Fibromyalgia is a neurologic condition that causes pain across most or all of the body. A neurologic condition is one that affects the nervous system. Fibromyalgia affects 2 to 4 percent of people. More women than men have the condition.
The primary symptoms of fibromyalgia are:
- pain or tenderness in muscles, joints, or skin from touch or pressure
- severe fatigue
- sleep difficulties
- memory difficulties
- foggy thinking
Even though fibromyalgia is a common condition, it's very challenging to diagnose. Diagnosis can be a lengthy process of ruling out other diseases and medical conditions. This process could even take years for some people.
In the past, fibromyalgia hasn't had a specific diagnostic test. However, some doctors and researchers think they may have found one in the FM/a test. Let's take a look at current methods of reaching a diagnosis of fibromyalgia as well as the FM/a test.
The symptoms of fibromyalgia are often similar to those of other conditions. Before your doctor considers a diagnosis of fibromyalgia, they'll want to rule out these conditions. The conditions that have symptoms that resemble fibromyalgia are:
- hypothyroidism (underactive thyroid)
- polymyalgia rheumatica (aching and stiffness across the whole body)
- rheumatoid arthritis (RA) (an autoimmune inflammatory disease that affects joints and organs)
- lupus (an autoimmune inflammatory disease that affects the kidneys, brain, blood cells, heart, lungs, and sometimes joints)
These conditions can be diagnosed, or ruled out, through blood tests. Some blood tests your doctor may order to rule out other conditions include:
- Complete blood count. This test includes a count of your red blood cells, white blood cells, and platelets. It also tests the amount of hemoglobin in your blood.
- Thyroid hormone tests. These tests measure how well your thyroid is working and can help your doctor diagnose hypothyroidism.
- Antinuclear antibody (ANA) test. This test determines if you have these types of antibodies and can help your doctor diagnose RA.
- C-Reactive protein test. This test looks for a substance produced by the liver that is a marker for inflammation.
- Erythrocyte sedimentation rate test. This test examines how quickly red blood cells settle in the bottom of a test tube. It can help your doctor diagnose polymyalgia rheumatica.
If these tests are negative for these similar conditions, then your doctor will start looking more at a possible fibromyalgia diagnosis.
There have been some promising studies on a possible diagnostic blood test for fibromyalgia. It's called an FM/a test. The test collects plasma and peripheral blood mononuclear cells (PBMC) in a small sample of your blood. It tests the concentration of cytokines within your blood sample.
Significantly lower levels of cytokines may be an indicator of fibromyalgia. Abnormal levels of cytokines have been linked to being a trait in people with fibromyalgia. Because of this link, researchers are hoping that the FM/a test may prove to be a way to more definitively diagnosis fibromyalgia.
The research that has been done up to this point does show promise that the FM/a test may be able to diagnose fibromyalgia. However, more clinical trials need to be done before this test will be fully recognized as a diagnostic tool for fibromyalgia.
There are some steps that you can take to help determine if you might have fibromyalgia. These steps are part of the diagnostic criteria and information that your doctor will need to know before being able to give you a correct diagnosis. Gathering this information before making a doctor's appointment will help your doctor better determine the next steps in your diagnosis.
Some of the steps to test yourself are:
- keep a pain journal that answers these questions:
- where does it hurt?
- how long does the pain continue?
- what activities were you doing, if any, prior to the start of the pain?
- how long have you been noticing your pain?
- has it been present for more than three months?
- Check the tender points
- keep a sleep journal that tracks how rested you feel when you wake up and throughout the day
After you collect this information, if you think you may have fibromyalgia, you should make an appointment to see a doctor. Your doctor will ask you a number of questions. The information gathered in your journal will help you answer those questions.
Currently, most doctors still use the traditional criteria for diagnosing fibromyalgia. This diagnostic process includes:
- interviewing you about your specific symptoms and their severity
- checking the number of symptoms you have and the number of body regions that are painful
- ordering blood tests to rule out similar diseases and conditions
- taking X-rays and scans to also rule out other diseases and conditions if indicated
- finding your widespread pain index (WPI) score
The FM/a test is still new and subject to research. Many doctors may not use it yet, and insurance companies most likely will not cover the cost. However, even with the FM/a test, it's likely that your doctor will still use the current diagnostic criteria as confirmation.
Primary care doctors are now much more familiar with fibromyalgia and its symptoms than they were in the past. This familiarity will help you get a diagnosis more quickly while the FM/a test continues through additional clinical trials.
If you're interested in having the FM/a test, talk to your doctor. It may be an option for you. Your doctor may also recommend that you get some information on possibly participating in a clinical trial for the test.