Fibromyalgia - Diagnosis 

Diagnosing fibromyalgia 

If you think you may have fibromyalgia, visit your GP. Diagnosing fibromyalgia can be difficult, as there is no specific test that can diagnose the condition. The symptoms of fibromyalgia can be varied and very similar to those of several other conditions.

Your GP will diagnose fibromyalgia based on you having a typical mix of symptoms and ruling out any other conditions that could be causing these.

Visiting your GP

Your GP may ask you about:

  • your pain
  • your symptoms
  • if you have any other conditions
  • how the symptoms affect your daily life
  • if you are taking any medicine

You may also have a physical examination, where your GP will check your entire body for any visible signs of other conditions, to rule out fibromyalgia. For example, swollen joints would suggest rheumatoid arthritis, rather than fibromyalgia.

Ruling out other conditions

If your GP thinks you may have fibromyalgia, they will first have to rule out any other conditions that could be causing your symptoms. These conditions include:

  • chronic fatigue syndrome (also known as myalgic encephalomyelitis, or ME) - a condition that causes long-term tiredness
  • rheumatoid arthritis - a condition that causes pain and inflammation (swelling) in the joints
  • multiple sclerosis (MS) - a condition of the central nervous system (the brain and spinal cord) that affects movement and balance

You may have blood tests, X-rays and other scans to rule out these and any other condition with symptoms similar to fibromyalgia. If you are found to have another condition, you could still have fibromyalgia as well.

Diagnosing fibromyalgia

Once all other conditions have been considered or ruled out, there are two criteria that can be used to confirm a diagnosis of fibromyalgia. If your symptoms fit within these criteria, it is likely you will be diagnosed with fibromyalgia.

The criteria for diagnosing fibromyalgia are:

  • widespread pain for more than three months on both the left and right sides of your body, above and below your waist
  • pain in at least 11 of the 18 'tender points' when they are pressed

Tender points

The tender points are the areas on your body where your pain is likely to be at its worst. They are places on the body where everyone is most sensitive to pain, so if you have fibromyalgia, these areas will be very painful.

There are tender points at the back of your neck, above each of your shoulder blades and the inside of your elbows. Your GP may also press other areas that are not tender points, to compare how much more painful the tender points are.

Additional conditions

It is also possible to have other conditions alongside your fibromyalgia. For example:

If your symptoms suggest you have another condition as well, you may need further tests to diagnose these. Identifying all possible conditions will help to guide your treatment. 

  • show glossary terms

Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

X-ray
An X-ray is an imaging technique that uses high-energy radiation to show up abnormalities in bones and certain body tissue, such as breast tissue.

Last reviewed: 31/03/2010

Next review due: 31/03/2012

Comments

4 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

Discarded said on 11 May 2012

the rheumy I saw wasn't interested all. She arranged a chest xray and xray on my hands???? Neither of them giving me any problems back then. Gave me a very quick and I mean extremely quick examination then diagnosed me as having fibromyalgia. I don't get shooting pains in my neck or back. I don't get any burning sensations anywhere in my body. I just get a severe aching pain in all my muscles that make it impossible for me to lift my arms or legs, sit up for long or stand up for long before I feel my whole body is being crushed. Every blood test I have done shows very high white cells that don't lower after anti biotics, but no further investigations have ever been carried out. I also show higher levels than normal for inflammation, but again never had scans or other xrays to investigate further. I never manage a full nights sleep due to waking in extreme pain that causes me to cry out when I try to move. I can't eat anything solid as it is too painful when I try to swallow it, even water can be painful to swallow. I'm tachicardic on resting with a heart rate of 120 -140 again never been investigated. I can walk about 50 metres before I have to start dragging my legs as my muscles become too heavy and achy to lift. Same with my arms and shoulders. Writing this is hard work as my arms and shoulders now feel like lead weights and muscles are starting ache so bad I have to keep stopping.
My GP is trying to be very supportive as far as the rheumy's diagnosis is concerned but I've read and read of other people's symptoms of fibromyalgia and I just don't seem to be able to relate to them. Yes, I do have chronic fatigue (can be caused by the meds I'm on) Severe memory loss (a side effect of another med I'm on) Oh! and severe stiffness, severe pain and severe fatigue when I wake up in a morning (these are the only things I can relate to for fibromyalgia) I think the NHS are now too ready to diagnose people with fibro to save money on further tests.

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Madijo said on 29 August 2011

I was diagnosed with M.E at 18 years old, from which a year later I managed to 'fully recover' and didn't think about it again until about 3 years ago. In that 7 years of wellness, I completed a degree had various jobs and trained to become a dance teacher. i got to teach for aout 6--7mnths before one day I woke up unable to move, paralysed in my bed.
I had to fight for help this time as had a mortgage and was holding down 4 jobs just to pay my bills. By the time i got to the stage of managing to afford to live, I became ill. Having to puch myself through the illness whilst waiting for benefits prolonged my condition, then having to fill in forms, and eventually getting my MP on board to get my doctor to write a simple letter, I finally got help (DLA).

You literally have to beg your GP to get further tests done. The above NHS guidelines are not being followed and people are suffering more because of it. Simply prescribing anti-depressants after one visit is not helping. We need ongoing support and re-evaluation every 6 months. Gp's also need to take notes about what we tell them and perhaps some Continual Proffessional Development on conditions such a M.E. and FM, because they seem to know very little. I had to do this as a masseuse, so why don't they. It's their proffession, yet they seem so disinterested. come on, it's your job!

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Trixie Trishaw said on 11 May 2011

I was diagnosed with Fibro Myalgia about 12 years ago. This was of course after years of being considered an 'attention seeker' My concern is that once one had a diagnosis, any worsening or extra problems are laid at the door of the original diagnosis and it is very difficult without getting very demanding to qualify for any further investigations. Also has anyone any knowledge of the accuracy of the information that Fybro Myalgia has been linked to Haemachromatosis. If this is the case then Fibro Myalgia suffers should perhaps have a blood test for Haemachromotosis as is this could far more serious. As I have also been diagnosed with a liver problem (not alcahol related) and Haemachromatosis also damages the liver I think I will check with my GP to see if they have already carried out a blood test for Haemachromotosis.

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TheDragonlady said on 30 May 2009

i had all the tests available - loads of bloods, 4 M.R.I. 's to rule out M.S. & ankylosing spondylosis , 3 Rose Waaler tests to rule out reumatoid arthritis, & countless X-Rays. Bearing in mind that i didnt have my first X-rays until i was 21 and my 1st M.R.I. shortly after. my idea would be to go ahead with all the tests to exclude all the other possible conditions. KEEP LOOKING there is an answer out there. xxxx

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