Diagnosis of fibromyalgia is complicated and requires that specific criteria be met during examination by your doctor 4. Although no diagnostic tests exist for this syndrome, the U.S. Food and Drug Administration recognizes fibromyalgia as a disorder, and the American College of Rheumatology has released criteria for its diagnosis 156. Also, the U.S. Department of Health and Human Services has released guidelines for the management of fibromyalgia syndrome in adults 2. Fibromyalgia presents myriad symptoms, which often require individualized treatment.

Diagnosing Fibromyalgia

It has been estimated that fibromyalgia affects nearly 10 million Americans. The syndrome can be difficult to diagnose because common symptoms like fatigue, headache, depression and muscle pain mimic many other conditions. Often, individuals visit many different doctors, presenting a constellation of symptoms. Diagnostic criteria from the American College of Rheumatology in 2010 state that fibromyalgia patients must meet certain widespread pain index and symptom severity scores, the symptoms must be present for at least 3 months and no other disorder can be found to explain their pain 156.

Investigating Musculoskeletal Symptoms

Chronic, widespread muscular pain that comes and goes is the common complaint among those suffering from fibromyalgia 4. Common areas of pain include:

• the upper neck
  
• collarbones
  
• backs of shoulders
  
• elbows
  
• knees
  
• upper buttocks

Pressure testing of these areas often produces pain. Upon waking, even after long periods of sleep, individuals often feel unrefreshed and stiff. Additionally, muscular pain can be present in the abdomen, pelvis and facial muscles. Pain in the neck, shoulders, face and jaw can sometimes lead to headaches and migraines.

Displaying Nervous System Symptoms

Fibromyalgia is considered a musculoskeletal disorder, but increasing evidence implicates the central nervous system as the core problem 4. According to a 2008 article in the "American Medical Association Journal of Ethics," abnormal brain waves during sleep, atypical pain neurochemicals in spinal fluid and other abnormal brain response measurements have been found in those who suffer from fibromyalgia 15. Depression, sleep problems, cognitive difficulty and sensitivity to loud noise or bright lights are all possible symptoms of fibromyalgia involving the nervous system.

Discovering Other Symptoms

The Centers for Disease Control and Prevention list irritable bowel syndrome and painful menstrual symptoms as possible symptoms of fibromyalgia. Additionally, severe fatigue often plagues those who have fibromyalgia, which can cause problems with family, friends and co-workers. Other symptoms that can occur include difficulty swallowing, dry mouth, vision problems and restless leg syndrome. Multiple symptoms involving a variety of body systems often make it difficult for doctors to recognize and diagnose fibromyalgia.

Misunderstanding the Cause

Fibromyalgia presents a puzzle to both doctors and patients. The cause of fibromyalgia is unclear 4. Often, symptoms develop following stressful life events, such as physical trauma, emotional stress, infectious illness or an environmental exposure. Sometimes several family members will have fibromyalgia, which might indicate a genetic component. Misunderstandings surround fibromyalgia as a real problem because no clear-cut diagnostic test or proven treatment exists, but as researchers learn more about it, new medications and treatment options continue to develop 4.