Exams and Tests

There are no specific tests that can confirm a diagnosis of fibromyalgia. You will likely have lab tests to make sure that you don't have another condition causing your symptoms. Your doctor will also ask questions about your medical history and do a physical exam.

Doctors use a set of criteria to diagnose fibromyalgia. Your doctor will look for:

• Widespread pain that has been present for at least 3 months. Pain is considered to be widespread if it is above and below your waist and on the right and left sides of your body.
• Pain and tenderness at 11 or more of 18 specific spots. The pain usually occurs only when the areas are pressed. Experts call these tender points. But you may also hear them called trigger points. (Some people may have fewer than 11 tender points but still may have fibromyalgia.)

A person may not meet these criteria but may still have fibromyalgia. That is why diagnosis can be so difficult.

Treatment Overview

There are many steps you can take to manage your symptoms. Treatment is focused on managing pain, fatigue, depression, and other symptoms common in fibromyalgia. The goal is to break the cycle of increased sensitivity to pain and decreased physical activity.

The treatment you need or want may be based on:

• How bad your symptoms are.
• Whether the condition is disrupting your daily life.
• What kinds of changes in your life you are willing and able to make.

Exercise

Getting consistent exercise, especially cardiovascular exercise, is one of the best ways to manage fibromyalgia. Pool exercise has been found to work well for many people.²

It's important to build up your exercise program slowly so you don't get sore muscles that cause you to want to stop exercising. Working with a physical therapist familiar with fibromyalgia may be helpful.¹

For more information, see Exercise and Fibromyalgia.

Medicines

Medicines are part of the long-term treatment of fibromyalgia. Medicines can help you sleep better, relax your muscles, or relieve muscle and joint pain. Your doctor may suggest prescription medicines, such as antidepressants, muscle relaxants, and anticonvulsants. Or he or she may suggest nonprescription pain relievers.

Not all people with fibromyalgia will need, want, or benefit from medicines. You might need to try one medicine before finding one that works best for you. You may also find that a medicine that has been helping your symptoms seems to not work as well over time. To learn more about medicines, see Medications.

Counseling

Cognitive-behavioral therapy and other forms of counseling, including hypnotherapy, have been shown to help people who have fibromyalgia.²

Counseling can help you learn to manage your pain, learn to relax, and reduce stress. These can help decrease pain and fatigue. And it can improve your mood and help you function.²

Taking care of yourself over time

Taking care of yourself is a vital part of managing fibromyalgia. For example you can:

• Identify sleep problems, if you have them. Then learn about ways to get more restful sleep.
• Relieve pain and stiffness with medicines and heat.
• Identify "triggers" that seem to make your symptoms worse. Then you can learn to avoid or manage them. Triggers may be a change in the weather, certain activities, stress, or a lack of sleep.
• Talk to your doctor if you have signs of depression or anxiety.

With help, you will be able to start working on most of these goals at home. You may have a team of health professionals to help you. To learn more, see Home Treatment.

Because the symptoms of fibromyalgia can come and go, you may find it hard to judge whether a particular treatment is really working. Different people may respond differently to each type of treatment. Many people with fibromyalgia have other joint or muscle diseases (such as rheumatoid arthritis or lupus) that need to be treated too.

Finding a treatment can take time. You may have to try several different treatments to find an approach that works for you.