Why Is It So Hard to Diagnose Fibromyalgia?

Could your symptoms of chronic pain, stiffness, and fatigue be fibromyalgia? It may take some time to find out for sure. People often visit multiple doctors before getting a diagnosis of fibromyalgia. Sometimes the search for answers can take years.1

See How to Get a Fibromyalgia Diagnosis

man with neck pain Several medical professionals can diagnose fibromyalgia, including family practice physicians, internists, and rheumatologists. See Arthritis Treatment Specialists

The delay can seem odd in a medical system that is so advanced in other ways, but there are several reasons diagnosing fibromyalgia can be difficult.

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There’s no diagnostic test for fibromyalgia

The lack of a widely accepted diagnostic test confirming fibromyalgia is a major stumbling block. Our modern medical system relies on diagnostic tests for many conditions. If your doctor suspects fibromyalgia, you may be given a battery of tests and scans, but these are usually done to see if your symptoms are coming from something other than fibromyalgia. Other conditions must be ruled out before a diagnosis of fibromyalgia is made.

See Are My Painful Joints Caused By Rheumatoid Arthritis or Something Else?

There are no obvious physical signs

Pain and inflammation can be widespread with fibromyalgia, but no one would know it from looking at you. Children with fibromyalgia occasionally have some short-term swelling, but not adults. In some cases, the doctor may order an electromyography, or EMG, to assess electrical activity in the muscles, but most tests don’t show damage caused by fibromyalgia.

Fibromyalgia is usually not the only problem

Most people with fibromyalgia also have at least one other major condition, meaning the doctor has to figure out which symptoms are part of fibromyalgia and which are due to something else.

See Conditions Related to Inflammatory Arthritis

These added issues are called coexisting conditions, and can run the gamut from the jaw problem known as temporomandibular joint dysfunction to irritable bowel syndrome. Other rheumatic conditions are especially likely to occur in those with fibromyalgia. An estimated 25% to 65% of people with fibromyalgia also have systemic lupus erythematosus, ankylosing spondylitis, or rheumatoid arthritis.

See Ankylosing Spondylitis Characteristics

Symptoms may come and go

Like many people with chronic pain, people with fibromyalgia tend to have good days and bad days. With fibromyalgia, though, symptoms sometimes disappear for days, weeks, or even months.

See Characteristic Symptoms of Fibromyalgia

If symptoms vanish before a doctor’s appointment, the patient may have more trouble pinpointing the exact location of pain during a physical examination.

Symptoms often mimic other conditions

Common symptoms of fibromyalgia tend to be vague. In addition to chronic pain and stiffness—sometimes described as a flu-like feeling—these are some typical symptoms:

  • Sensitive areas of the body called tender points
  • Feeling tired no matter how long you sleep
  • Short-term memory loss or often feeling foggy-headed.

See How Rheumatoid Arthritis Causes Fatigue

Symptoms typical of fibromyalgia are similar to multiple medical conditions. These are several conditions that may be mistaken for fibromyalgia:

  • Anemia
  • Chronic fatigue syndrome (myalgic encephalomyelitis)
  • Depression and anxiety
  • Myofascial pain syndrome, a regional pain syndrome
  • Multiple sclerosis, myasthenia gravis, and other neurological conditions
  • Other rheumatic conditions, such as rheumatoid arthritis, osteoarthritis, Sjogren’s Syndrome, and systemic erythematosus lupus
  • Underactive thyroid, or hypothyroidism

See Is My Joint Pain Caused by Rheumatoid Arthritis or Another Autoimmune Disorder?

If you are currently seeking a diagnosis for fibromyalgia or a similar condition, one thing you can do to help your doctor pinpoint the cause is to keep a log of symptoms during the weeks leading up to a doctor’s visit. Include details like the time of day, the severity of symptoms, how long they last, and what you were doing before they occurred.

Learn more:

Multi-Specialty Fibromyalgia Treatment

Medications to Ease Fibromyalgia Symptoms

References:

  1. Arnold LM, Gebke KB, Choy EH. Fibromyalgia: management strategies for primary care providers. Int J Clin Pract. 2016;70(2):99-112.
Post written by Louise Donahue