Fibromyalgia Diagnosis – How Is Fibromyalgia Diagnosed?

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The diagnostic criterion for fibromyalgia was established in 1990 by the American College of Rheumatology (.SCR). It defined fibromyalgia as “… a painful, but not articular [not present in the joints], condition predominantly involving muscles and is the most common cause of chronic widespread musculoskeletal pain.”

In 1993, the World Health Organization held the Second World Congress on Myofascial Pain and Fibromyalgia, and officially recognized the ACR’s criteria for diagnosis in The Copenhagen Declaration.

How Fibromyalgia is Diagnosed:

The ACR’s criteria of classification of fibromyalgia was based on a blinded, multi-center study that evaluated 11 symptom variables including sleep disturbances, frequent headaches, and stress levels.

The study reported two decisive findings, which are now the basis of diagnosis:

Widespread pain was present in 98 percent of fibromyalgia patients, compared with 69 percent of the control group.

• Widespread pain is defined as pain in the left and right side of the body, above and below the waist, as well as axial skeletal pain (such as in the neck, front or back chest, and lower back).
• Pain in I I of 18 tender points was reported on digital palpation (tender is not considered painful); 88.4 percent of fibromyalgia patients had widespread pain in combination with pain in 11 of 18 tender points as described.

Therefore, if you have a history of widespread pain for more than three months and the health-care professional finds 11 or more tender points upon physical examination, a diagnosis of fibromyalgia can be made.

Although these criteria for diagnosis lack a specific “marker” for laboratory testing (such as a blood test, urine test, x-ray, and so on) and have been described as subjective, most researchers agree that they have been a beneficial tool for clinical research. They also point out that many other illnesses do not have a definitive laboratory test to prove their diagnoses.

For now, tender points have been found to be very consistent sites for diagnosing individuals with fibromyalgia.

As we better understand the cause(s) of fibromyalgia, new diagnostic criteria may emerge in the future.

During a diagnosis, the health-care professional will press firmly on 18 (a total of 9 pairs of) designated tender points located in the following areas:

• The left or right side of the back of the neck, directly below the hairline
• The left or right side of the front of the neck, above the collarbone (clavicle)
• The left or right side of the chest, right below the collarbone
• The left or right side of the upper back, near where the neck and shoulder join
• The left or right side of the spine in the upper back between the shoulder blades (scapulae)
• The inside of either arm, where it bends at the elbow
• The left or right side of the lower back, right below the waist
• Either side of the buttocks right under the hipbones
• On the fat pad over the kneecaps

If 11 or more tender points are reported to be painful, the health-care professional may make a fibromyalgia diagnosis. Although these tender points are helpful in the diagnosis of fibromyalgia, they do not determine the severity of fibromyalgia symptoms.