Diagnosis of Fibromyalgia
The diagnosis of fibromyalgia can be challenging, as there is no single test to confirm the condition. Fibromyalgia is diagnosed based on a combination of clinical symptoms, medical history, and the exclusion of other conditions with similar presentations. Due to the complexity and variety of symptoms, diagnosis often takes time and may involve several healthcare providers.
Clinical Evaluation
Doctors start by taking a full medical history and asking about:
Widespread pain, including when and where it occurs
Sleep patterns, including insomnia or non-refreshing sleep
Cognitive issues, like memory and concentration difficulties
Fatigue levels and how daily life is affected
Digestive symptoms, mood changes, or sensory sensitivities
The healthcare provider will also ask about previous illnesses, medications, and any personal or family history of chronic pain or autoimmune disorders.
Diagnostic Criteria
The current diagnostic guidelines for fibromyalgia include:
Widespread pain index (WPI) and symptom severity score (SSS)
Symptoms must be present for at least three months
No other condition should better explain the symptoms
Pain must be felt in multiple areas of the body
The older “tender point” examination is no longer required but may still be used informally in some clinical settings.
Exclusion of Other Conditions
Because fibromyalgia shares symptoms with many other illnesses, doctors may order tests to rule out:
Rheumatoid arthritis
Lupus
Hypothyroidism
Multiple sclerosis
Anaemia or vitamin deficiencies
Tests may include blood work, thyroid panels, inflammatory markers, and sometimes imaging.
Referral to Specialists
If diagnosis is uncertain or symptoms are complex, referral to:
Rheumatologists (who specialise in musculoskeletal pain)
Neurologists (for neurological symptoms)
Pain clinics or multidisciplinary teams specialising in chronic pain
Mental health professionals may also help rule out or support co-existing conditions like depression, anxiety, or trauma-related disorders.
Challenges in Diagnosis of Fibromyalgia
People may dismiss symptoms, especially in women or those with multiple diagnoses
Patients may go undiagnosed for years
Stigma and misunderstanding still exist, despite growing awareness
A timely and accurate diagnosis of fibromyalgia can provide relief, validation, and access to effective treatment and support.
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