Fibromyalgia: Understand the diagnosis process
Fibromyalgia symptoms often mimic those of other conditions. Determining the true cause of your symptoms is key to receiving proper treatment.By Mayo Clinic Staff
Fibromyalgia symptoms include widespread body pain, fatigue, poor sleep and mood problems. But all of these symptoms are common to many other conditions. And because fibromyalgia symptoms can occur alone or along with other conditions, it can take time to tease out which symptom is caused by what problem. To make things even more confusing, fibromyalgia symptoms can come and go over time.
That's why it can take a long time to go from fibromyalgia symptoms to a fibromyalgia diagnosis.
No specific test for fibromyalgia
Fibromyalgia can't be easily confirmed or ruled out through a simple laboratory test. Your doctor can't detect it in your blood or see it on an X-ray. Instead, fibromyalgia appears to be linked to changes in how the brain and spinal cord process pain signals.
Because there is no test for fibromyalgia, your doctor must rely solely on your group of symptoms to make a diagnosis.
In the American College of Rheumatology guidelines for diagnosing fibromyalgia, one of the criteria is widespread pain throughout your body for at least three months. "Widespread" is defined as pain on both sides of your body, as well as above and below your waist.
Old guidelines required tender points
Fibromyalgia is also often characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points. In the past, at least 11 of these 18 spots had to test positive for tenderness to diagnose fibromyalgia.
But fibromyalgia symptoms can come and go, so a person might have 11 tender spots one day but only eight tender spots on another day. And many family doctors were uncertain about how much pressure to apply during a tender point exam. While specialists or researchers may still use tender points, an alternative set of guidelines has been developed for doctors to use in general practice.
These newer diagnostic criteria include:
- Widespread pain lasting at least three months
- Presence of other symptoms such as fatigue, waking up tired and trouble thinking
- No other underlying condition that might be causing the symptoms
Excluding other possible causes
It's important to determine whether your symptoms are caused by some other underlying problem. Common culprits include:
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- Rheumatic diseases. Certain conditions — such as rheumatoid arthritis, Sjogren's syndrome and lupus — can begin with generalized aches and pain.
- Mental health problems. Disorders such as depression and anxiety often feature generalized aches and pain.
- Neurological disorders. In some people, fibromyalgia causes numbness and tingling, symptoms that mimic those of disorders such as multiple sclerosis and myasthenia gravis.
See more In-depth
- Clauw DJ. Fibromyalgia: A clinical review. JAMA. 2014;311:1547.
- Goldman L, et al., eds. Fibromyalgia, chronic fatigue and myofascial pain. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed June 21, 2017.
- Ferri FF. Fibromyalgia. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed June 21, 2017.
- AskMayoExpert. Fibromyalgia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
- Goldenberg DL. Clinical manifestations and diagnosis of fibromyalgia in adults. https://www.uptodate.com/contents/search. Accessed June 21, 2017.
- Goldenberg DL. Differential diagnosis of fibromyalgia. https://www.uptodate.com/contents/search. Accessed June 21, 2017.