We all have aches and pains. We all suffer from bouts of fatigue and irritability. We all have those “off days” where it’s difficult to concentrate, remember things, and follow conversations. So, how can you know if you’re suffering from an illness or just not feeling well for any of a hundred reasons? With fibromyalgia, there are some key indicators that can tell you it’s time to see your doctor.
It requires a good bit of history for a Rheumatologist to make the diagnosis of Fibromyalgia—sometimes this can take years. That makes it important for patients to be open with the doctors who treat them, and to have the knowledge of what they need to bring up during appointments. Another complicating factor in the diagnosis of Fibro is that everyone feels it differently—everyone has a different set of symptoms. Sit in a room with ten Fibromyalgia sufferers, and you will get ten different descriptions of the disease, with some overlapping symptoms.
Chronic, wide-spread pain is at the top of the list of Fibro symptoms. To be considered wide-spread, the pain must occur on both sides of the body, and both above and below the waist. Some of the pain patients feel is muscular—particularly a pronounced tenderness in the muscles—and some is felt in the joints. This pain is typically worse in cold weather than when it’s warm, and insufficient sleep will generally make it worse. In particular, there are “tender points” present in Fibromyalgia. These may be the single most important pieces of information involved in the diagnosis of Fibromyalgia.
There are eighteen tender points on the body of a Fibro patient. These are small areas, frequently located near (but not on) joints, that cause enough pain when pressed to cause a patient to flinch or pull away from the doctor doing the examination. Even if you are in pain all over your body, the pressure on these tender points will get your attention quickly, as the pain is very aggressive and intense.
To get a diagnosis of Fibromyalgia, pain has to be present in at least eleven of the eighteen tender points. These penny-sized areas of pain are located on each side of the body, above and below the waist. You can find a diagram of the tender points here.
Fatigue is also a huge indicator. In fact, many people suffer from both Fibromyalgia and Chronic Fatigue Syndrome. This is fatigue that goes far beyond being tired after a long day at work—it is debilitating and not alleviated by sleep (generally because people with Fibro do not get truly restful sleep). This debilitating fatigue must be present for at least three months.
Another factor in the diagnosing process is time. As with fatigue, pain must have been present for at least three months in order for a doctor to diagnose Fibromyalgia. This is possibly the only good part of it taking so long for most people to get an accurate diagnosis—a medical record full of reports of unexplained, chronic pain generally exists.
People with Fibromyalgia commonly spend months or years looking for an explanation for their pain and fatigue, but being knowledgeable about the other symptoms could help them find relief faster. Other symptoms include IBS, frequent migraines or tension headaches, interstitial cystitis, tenderness in the face or jaw, dizziness, intolerance to heat and strenuous activity, anxiety and depression, and tingling or numbness in the extremities.
Generally, a Rheumatologist makes the final diagnosis of Fibromyalgia, but the diagnosis can also be made by a knowledgeable General Practitioner or by a Neurologist looking for a cause of chronic headaches. A good doctor is essential for living well with Fibromyalgia, but even a great doctor can’t make a diagnosis without enough information. If you suspect you or someone you love may have Fibromyalgia, do some research—keep a journal of symptoms and make a list of things to tell your doctor. Know which symptoms you have and what triggers (heat, cold, lack of sleep, hormonal changes from menstruation) make them worse. The more information you can give your doctor, the sooner you can get the help you need.