Fibromyalgia: Understand the diagnosis process

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:

  • 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.

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