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01 February 2010
Posted in
Tests and diagnosis
Diagnosing Fibromyalgia is not an easy task
Diagnosing Fibromyalgia is not an easy task becuase there are no difinitive tests for it, but contrary to popular belief it is not merely a digansosis because they have ruled everything out and don't know what's wrong with you. The diagnosis of Fibromyalgia is not the catch all waste basket diagnosis that some doctors, friends and family belive it to be. The first time I was told Fibromyalgia I didn't belive it either. Fibromyalgia has a long history and has existed dating back to the days of the bible. There are diagnostic criteria set forth by the American College of Rheumatology to help doctors diagnos Fibromyalgia.
FROM: How Is Fibromyalgia Diagnosed?
By Carol & Richard Eustice, About.com GuideNo Diagnostic Laboratory Tests For Fibromyalgia
Another reason fibromyalgia diagnosis remains difficult is that there are currently no diagnostic laboratory tests for fibromyalgia; standard laboratory tests fail to reveal a physiologic reason for pain. Because there is no generally accepted, objective test for fibromyalgia, some doctors unfortunately may conclude a patient's pain is not real, or they may tell the patient there is little they can do.
Diagnostic Criteria For Fibromyalgia
- A doctor familiar with fibromyalgia, however, can make a diagnosis based on two criteria established by the American College of Rheumatology:
- a history of widespread pain lasting more than 3 months
- the presence of tender points
- Pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia.
Fibromyalgia Tender Points
- The American College of Rheumatology also has designated 18 sites on the body as possible tender points. For a fibromyalgia diagnosis, a person must have 11 or more tender points.
- What are Fibromyalgia Tender Points?
- One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.
The key to a dignosis
The key to a dignosis of Fibromyalgia is a combination of several important factors. First you need a doctor that is a believer. You need a doctor that will take yous eriously and you will need this even after your diagnosis. Any other type of doctor you have for things unrelated to fibromyalgia needs to understand and take your fibromyalgia seriously. This is sometimes the biggest and most frustrating hurdle for newly diagnosed patients or those on the road to a diagnosis. Expect to have many tests as part of the diagnposis is ruling out other similar diseases and conditions.
- In 1990, the American College of Rheumatology (ACR) listed two primary criteria for the classification of fibromyalgia. 1) A history of widespread pain involving all four quadrants of the body (right side, left side, above waist, below waist) for a period of at least 3 months.
- The second criteria from the ACR which points to fibromyalgia is, upon physical examination, the presence of pain in at least 11 of 18 tender points when touched or pressed with force amounting to the equivalent of 4 kg. or 9 lbs.
Note: Not all doctors agree on the Tender Points as a criteria
Not all doctors agree on the Tender Points as a criteria however. Some patients may have all or fewer than 18 but that doesn't mean they do not have Fibromyalgia. Many Physicians do not like them and consider them to be arbitrary and I have to agree witht hat myself. How much pain I am in while being examined by my doctor could not only vary by day but vary by the time of day.
From: Fibromyalgia the first year
Author: Claudia Craig Clark
To make things complicated, not every physician agrees with the tender point meashurements. Many physicians have never liked them, and consider them to be arbitrary. Others, like R. Paul St. Amand, M.D. have pointed out that tenderness has more to do with pain thresholds than anything else. Also, as he is fond of remarking, "On a bad day, every inch of your body hurts. On a good day, you can tolerate alot more. Even in the same person pain thresholds vary tremendously.
- More recent data indicates that there may be an increased sensitivity to pain throughout the body, pain may be migratory (move around) or may exist as chronic regional pain. Most experts are said to believe fibromyalgia results from abnormal central nervous system function. Response to stress and psychobehavioral factors may also contribute to fibromyalgia.
- Fibromyalgia primarily occurs in women of childbearing age. Children, the elderly, and men can also be affected. Besides the defining symptoms of pain and tenderness, there are many nondefining symptoms associated with fibromyalgia including:
- Fatigue, night sweats and sleep disturbances.
- Memory difficulties and cognitive difficulties.
- Tension or migraine headaches, temporomandibular joint syndrome, rib cage pain (noncardiac chest pain), chronic pelvic pain, plantar or heel pain.
- Fluctuations in weight, heat or cold intolerance, subjective feeling of weakness.
- Ear-nose-throat complaints, multiple chemical sensitivities and a wide array of allergic symptoms.
- Hearing, vision, and vestibular (balance) abnormalities.
- Heartburn, palpitations and irritable bowel syndrome.
- Evidence on echocardiogram of mitral valve prolapse, esophageal dysmotility (muscles of esophagus not working properly), neurologic conditions causing hypotension (low blood pressure) and syncope (fainting).
- Mood disorders such as depression and anxiety occur more commonly in people who have fibromyalgia.
Resources:
Fibromyalgia the first year, Claudia Craig Merak.
How Is Fibromyalgia Diagnosed? By Carol & Richard Eustice, About.com
How To Recognize the Signs and Symptoms of Fibromyalgia, Carol & Richard Eustice, About.com Guide
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