How to Test for Fibromyalgia
Fibromyalgia is a common condition, affecting roughly 2% to 4% of people, with women being more commonly affected than men. It is a chronic neurologic condition that causes widespread pain and tenderness throughout the body.
Additionally, fibromyalgia can present with accompanying symptoms such as severe fatigue, sleep difficulties, and problems with memory and thinking. In some cases, fibromyalgia patients can also suffer from anxiety or depression, tension or migraine headaches, digestive issues, irritable or overactive bladder, TMJ disorder, and/or pelvic pain.
Unfortunately, fibromyalgia is difficult to diagnose because its symptoms mimic those of a variety of other health conditions. In some cases, getting a fibromyalgia diagnosis can take several years, leaving patients exhausted and frustrated. In this article, we will go over how to test for fibromyalgia, and what to expect during the process.
What is a Fibromyalgia Test?
Your doctor may suspect you have fibromyalgia based on your symptoms. Previously, doctors would evaluate 18 specific points on the body to determine how many were tender when firmly pressed. However, recent guidelines from the American College of Rheumatology no longer require a tender point exam to diagnose fibromyalgia.
The main determinant for diagnosing fibromyalgia is widespread pain throughout the body for a minimum of three months. In order to meet these criteria, you must have pain in a minimum of four of five areas, have a widespread pain index (WPI) score of seven or greater, and a symptom severity scale (SSS) score of 5 or greater. Or, you must have a WPI score of 3 to 6 and an SSS of greater than 9.
The pain regions include: the right upper region (jaw, shoulder, arm), left upper region (jaw, shoulder, arm), right lower region (buttocks, hip, leg), left lower region (buttocks, hip, leg), and/or axial region (back, neck, abdomen, chest).
Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) Explained
The WPI and SSS are used to evaluate for fibromyalgia.
The WPI is used to check for pain in 19 areas of the body. For each area of pain you have had in the past seven days, you receive one point. Your doctor will tally all your points to give you a score between 0 to 19.
The SSS is used to check for symptoms in four categories that are not related to pain, including fatigue, daytime sleepiness, cognitive issues, and other signs of fibromyalgia.
Your physician will ask you to rate the severity of your symptoms, on a scale of 0 to 3, over the past week. They will then tally your points for a score between 0 to12.
Ruling Out Other Health Conditions
One of the diagnostic criteria for fibromyalgia is that your symptoms are not caused by any other underlying medical condition. There are certain diseases that fibromyalgia can mimic including:
- Rheumatoid arthritis
- Lupus
- Sjogren’s syndrome
- Depression
- Anxiety
- Multiple sclerosis
- Myasthenia gravis
Additional Testing to Rule Out Other Health Conditions
Additional testing may be recommended to rule out other conditions that mimic fibromyalgia. Common tests include:
- Complete blood count
- Rheumatoid factor
- Erythrocyte sedimentation rate
- Thyroid function tests
- Cyclic citrullinated peptide test
- Anti-nuclear antibody
- Vitamin D and/or celiac serology
Other types of testing may include x-rays, CT scans and/or MRI scans, and biopsies. Further testing can include sleep studies and psychological assessments.
If these additional tests are negative for other conditions that may be causing your symptoms, your physician will be leaning towards a diagnosis of fibromyalgia.
Specialized Blood Test to Diagnose Fibromyalgia
The issue that many patients face is inconclusive fibromyalgia testing results. A newer blood test has shown promising results for providing a definitive diagnosis of fibromyalgia: the FM/a test.
This blood test collects plasma and peripheral blood mononuclear cells and tests the white blood cells for chemokine and cytokine patterns. These proteins arrange themselves irregularly in patients with fibromyalgia, allowing the FM/a test to correctly diagnose this condition via a simple blood test with results typically available in a week.
While the sensitivity of this test has been shown to be around 99%, additional clinical testing is needed before it becomes the gold standard for fibromyalgia diagnosis.
In Conclusion
If you are suffering with symptoms of fibromyalgia, it is a good idea to start a symptom journal to record the location and timing of your pain. This will allow you to give important details to your doctor to help them determine the cause of your symptoms.
They will take a detailed history of your symptoms, perform a physical examination, and use the WPI and SSS if they suspect fibromyalgia, and recommended additional testing to rule out other conditions that may be causing your symptoms.
Once you receive a diagnosis of fibromyalgia, you can begin a comprehensive treatment plan, including traditional medical management, alternative medicine, and lifestyle changes to help get your symptoms under control and improve your quality of life.