Ask a Doctor
Based on conversations with a friend who has fibromyalgia, I think I may also have the disease. I definitely have fatigue and muscle pain and tenderness. How do you diagnose fibromyalgia? How do you feel when you have fibromyalgia?
The most prominent symptom of fibromyalgia is widespread pain. Unlike arthritis, the discomfort is not in the joints, but in the muscles and ligaments. The pain is commonly located in the neck, shoulders, back, and hips. There is also diffuse tenderness, as if the sensory portions of the nervous system are extra sensitive. The tenderness is worse in the mornings and has been described as flu-like, burning, throbbing, aching, or stabbing.
No simple blood test or X-ray can tell you if you have fibromyalgia. The diagnosis is made solely by taking a history and doing a physical exam. Your doctor may still want to do blood tests or X-rays to rule out illnesses that mimic fibromyalgia.
According to the American College of Rheumatology, before the diagnosis of fibromyalgia can be made, the muscle pain must be present for longer than three months. Also, pain must occur at specific sites on the body called tender points. There are 18 of these sensitive spots. Most are located on the neck and back.
Your doctor makes the diagnosis by applying mild pressure to the tender points. If discomfort occurs at 11 or more of these points, then the physical exam is positive for fibromyalgia.
Other symptoms you may experience include the following:
- Fatigue: Another frequent complaint associated with fibromyalgia is fatigue. In fact, it occurs so commonly that some doctors think fibromyalgia and chronic fatigue syndrome are the same disease. The severity of the fatigue can range from mild to incapacitating. In its worse form, fatigue can be so debilitating that some people have trouble keeping their jobs. No amount of sleep at night or rest during the day is helpful for relief.
- Fibrofog: Another common symptom is a mental haziness some people call fibrofog. This refers to the inability to concentrate, memory loss, and depression that occurs with fibromyalgia.
- Other symptoms associated with fibromyalgia are insomnia, headaches, nervousness, numbness, dizziness, and intestinal disturbances, including irritable bowel syndrome (IBS).
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Firestein, G.S., et al. Kelley's Textbook of Rheumatology, Ninth Ed. Philadelphia, Pa: Saunders Elsevier, 2012.