How is Fibromyalgia Diagnosed?
No medical test or x-ray can provide
a definitive diagnosis of fibromyalgia.
Doctors typically use the American
College of Rheumatology's 1990 criteria for classifying fibromyalgia.
According to these criteria, a person is considered to have fibromyalgia
if he or she has widespread pain for at least 3 months in combination
with tenderness in at least 11 of 18 specific tender point sites.
Pain is considered widespread when
it occurs in both the left side of the body and the right side, and both
above and below the waist. Cervical spine, anterior chest, thoracic spine
or low back pain must also be present.
The "tender points" are
precise areas of the body which, when pressed, generate pain. The 18 tender
point sites include:
1. The area where the neck
muscles attach to the base of the skull, left and right sides ( Occiput)
2. Midway between neck
and shoulder, left and right sides ( Trapezius)
3. Muscles over left
and right upper inner shoulder blade, left and right sides ( Supraspinatus)
4. 2 centimeters below
side bone at elbow of left and right arms ( Lateral epicondyle)
5. Left and right upper
outer buttocks ( Gluteal)
6. Left and right hip
bones ( Greater trochanter)
7. Just above left
and right knees on inside
8. Lower neck in front,
left and right sides (Low cervical)
9. Edge of upper breastbone,
left and right sides ( Second rib)
To be considered painful, pressure
on the tender point must generate actual pain, not just tenderness.
Some physicians also conduct blood
work looking at levels of serotonin, substance P, adenosine triphosphate
(ATP), free cortisol, glucose, growth hormone, and other factors.
A complete guide to diagnostic factors, and how to get a timely diagnosis
is featured in the book Living
Well With Chronic Fatigue Syndrome and Fibromyalgia. You
can also find a condensed summary Online
Checklist version of the book’s detailed “Risks and Symptoms
Checklist.”
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Next: How is Fibromyalgia Treated?
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About
Mary Shomon: