FIBROMYALGIA (FM) DIAGNOSIS
Fibromyalgia syndrome (FM) is a diagnosis of exclusion. That means before doctors can give
you an FM diagnosis, they need to rule out a host of other conditions with similar
symptoms. Typically, they'll order blood tests for
hypothyroidism, infections, polymyalgia rheumatica,
rheumatoid arthritis or lupus.
Doctors may also order other lab and imaging tests. Until recently, no test could
definitively diagnose fibromyalgia, but a new blood test
is now showing promise in some preliminary studies. It involves antipolymer antibodies,
which may be found in about half of the people with Fibromyalgia.
Learn more by viewing the links below:
American College of Rheumatology
The American College of Rheumatology in 1992 established two criteria for a diagnosis of
Exams and Tests
Remember, these tests aren't to diagnose fibromyalgia; they're to eliminate any other
possible conditions. The doctor may order:
- Erythrocyte Sedimentation Rate (ESR):
An ESR test measures how quickly red blood cells fall to the bottom of a test tube. In
people with rheumatic disease (such as rheumatoid arthritis), the ESR or "sed rate" is
sometimes higher. The red blood cells fall quickly to the bottom of the tube, which
suggests that there is inflammation in the body.
- Rheumatoid factor (RF) Test:
In many patients with an inflammatory condition (such as rheumatoid arthritis, which has
symptoms similar to fibromyalgia), a higher level of the rheumatoid factor can be
identified in the blood. A higher level of RF doesn't guarantee that your pain is caused
by rheumatoid arthritis (RA), but doing an RF test will help your doctor explore the
possibility of an RA diagnosis.
- Infection Testing:
If your condition is suspected to have an infectious component, blood testing for common
antigens is necessary. Common culprits include Lyme's Disease, Epstein‐Barr Virus, and
Candida. In cases in which a specific antigen is not suspected, comprehensive panels to
assess for viral, bacteria, and fungal infections are most beneficial.
- Adrenal Stress Index (ASI):
The ASI monitors cortisol levels throughout a 12 hour period. Cortisol should be highest
in the morning and lowest at night. Many FM and CFS/ME sufferers show a different pattern.
This strongly suggests adrenal fatigue.
- Hormone Testing:
Since FM and CFS/ME are strongly related to the HPA Axis, and thus the hormone system, it
is important to test hormone levels. Important hormones to test include cortisol,
estrogen, progesterone, testosterone, and the thyroid hormones.
- Vital Signs:
Thyroid and adrenal dysfunction can often be suspected through heart rate, respiration
rate, blood pressure, and other observed signs.
- Cervical Xrays/MRI:
- Nutrient and Toxic Elements Panel:
This blood test assesses toxin exposure and nutrient levels in the body. These are factors
in many FM and CFS/ME cases.
- Natural Killer Cells (NKC):
Every FM and CFS/ME sufferer should know their NKC levels due to an increased risk of
cancer in people with chronic muscle pain, which is linked to low NKC levels.
- Other Tests:
There are many condition‐specific tests that may be beneficial in diagnosing and
determining the most appropriate treatments for your specific case.
Diagnosing fibromyalgia can take awhile. Your job as a patient is to be proactive in the
diagnostic process; be your own advocate.
For example, when your doctor orders a test, ask why. Be sure you understand what the
results will tell you and how that test will help figure out your pain. If you don't
understand the results or reasoning, keeping asking questions until you do.
Types of Doctors Treating Fibromyalgia
Here is a list of some of the doctors who specialize in treating FM and pain:
diagnose and treat arthritis and other
diseases of the joints, muscles, and bones. This includes FM, rheumatoid arthritis,
osteoarthritis, gout, lupus, back pain, osteoporosis, bursitis, and tendinitis.
are usually board certified anesthesiologists, neurologists,
physiatrists, psychiatrists, or oncologists with additional training in pain
management. They receive credentials from the American Board of Anesthesiology (ABA)
in collaboration with the American Board of Physical Medicine and Rehabilitation
(ABPMR) and the American Board of Psychiatry and Neurology (ABP&N). Or they may
receive credentials from the American Board of Pain Medicine.
diagnose and treat disorders of the nervous system. This includes
treating common pain problems such as headaches, back pain, muscle disorders,
FM, neuropathy (carpal tunnel syndrome), and reflex sympathetic dystrophy (RSD).
are doctors who specializes in physical medicine and
rehabilitation (PM&R). Physiatrists are specially trained to diagnose, manage, and treat
symptoms of acute and chronic pain. They also treat injuries and diseases of the
musculoskeletal and neuromuscular systems.
diagnose and provide therapy for problems associated with pain,
perception, and emotional issues.
Finding a doctor who's willing to effectively diagnose and treat fibromyalgia is still
difficult. To help in your search we have put together a database of doctors who treat
Fibromyalgia and/or CFS/ME.
Doctors who have been verified by us as treating Fibromyalgia are listed as
Treats FM. Doctors verified by us as treating CFS/ME
are listed as: Treats CFS/ME.
Doctors referred to us by one or more of their patients are listed as:
FM & CFS/ME
While Fibromyalgia (FM) and Chronic Fatigue Syndrome/
Myalgic Encephalomyelitis (CFS/ME) are two different
conditions, 50-70% of FM patients also meet the criteria for CFS/ME.
People with CFS/ME are often tired, while those diagnosed with FM complain of pain.
They often have swollen glands, sore throat, and fever which many FM
patients don't have. However, it's not unusual for FM patients to also have
CFS/ME. Researchers are still unsure if FM is the result of a virus, while most
agree that CFS/ME is viral in origin.
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