subject: Diagnosing Fibromyalgia [print this page] Fibromyalgia is commonly diagnosed by excluding a whole bunch of diseases and conditions that have similar symptoms but show different results in laboratory tests, as well as taking into account a thorough clinical history and physical examination. Some of the possible causes for symptoms that have to be ruled out include cancer, thyroid issues (especially hypothyroidism), infections, hormonal issues, anemia, rheumatoid arthritis, polymyalgia rheumatica, diseases of the nerves and musculoeskeletal diseases (whether of the bones, joints or muscles). Diagnosis might require blood tests, the use of X rays, electromyography and other medical tests.
The physical exam usually yields information on what is known as "tender points": well defined spots in the patients' body where a slight pressure can result in pain. There are two terms related to this pain sensitivity that are of interest in fibromyalgia: allodynia (feeling pain due to a stimulus that normally would not elicit it) and hyperalgesia (an increased sensitivity to pain). A significant majority of tender points, as well as widespread localization of pain is needed to comply with the diagnostic criteria. Widespread pain implies pain both on the right and left side of the body, below and above the mid-section, and also involving neck, chest, waist or lower areas of the back. Tender points are thus bilateral, and located at very specific spots (great images of their situation are available in the Internet).
Other symptoms usually affecting the fibromialgic patient are painful periods (90% of patients are women), fatigue, sleep disorders (which might include insomnia, unrestful sleep, frequent awakenings, restless legs syndrome, etc.), jaw pain/ temporomandibular joint disfunctions (bruxism is a frequently associated condition), chronic headache (migraine incidence is higher in fibromialgic patients), irritable bowel syndrome (e.g. with diarrhea, constipation or the alternation of both, feeling bloated, flatulence, pain/cramping in the abdomen), cognitive difficulties (e.g. memory & decision making issues), dizziness, stiffness, and sensations like tingling or numbness that usually affect the extremities.
Most patients diagnosed with fibromyalgia have low levels of physical activity and lead a sedentary life. Smoking has also been significantly linked to the development of sensitivity syndromes like fibromyalgia, particularly in women. Studies have shown that in fibromyalgic patients there is a biochemical imbalance in the central nervous system. Some researchers have pointed out that fibromyalgia is not really an accurate name for the disease, as pain is not based in the fibres but the result of a systemic physiological hyper-excitability condition; 'myalgia of the central nervous system' has been proposed as an alternative name.
