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Common Misdiagnoses of Fibromyalgia

Fibromyalgia is a condition marked by widespread chronic pain and fatigue with no known cause. It's not fatal. Though the pain may not have been caused by an injury, it is real.

When fibromyalgia is diagnosed and treated properly, most people have a significant reduction in symptoms and a much better quality of life.

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Fibromyalgia: Work and Disability

Many people with fibromyalgia continue to work full or part time. But the chronic pain and fatigue associated with fibromyalgia often make working very difficult. If you are employed, it's important to learn about managing fibromyalgia symptoms and coping with pain and fatigue. In addition, if you have tried different jobs and are unable to work, you might consider applying for disability. Disability may be difficult to get because of rules about work capacity.  

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But diagnosing fibromyalgia is often difficult. Its symptoms can mimic those of other conditions.

Here's a look at the common ways that fibromyalgia can be misdiagnosed.

Symptom Overlap

The main symptom of fibromyalgia is widespread pain. You can have pain on the right and left side of the body. It can also be above and below the waist. But the pain may also occur in only one or two places in the body, especially the neck and shoulders.

A diagnosis of fibromyalgia can be tricky because fibromyalgia isn't the only condition with widespread pain.

Besides pain, another major symptom of fibromyalgia is chronic fatigue. But patients with other conditions also have chronic fatigue.

There are other symptoms that may occur in fibromyalgia. But just like pain and fatigue, the symptoms are experienced by patients with other conditions. These symptoms include:

  • Thinking and memory problems (fibro fog)
  • Headaches, both tension and migraine
  • Sensitivity to temperature, light, and noise
  • Irritable bowel syndrome
  • TMJ syndrome
  • Morning stiffness
  • Numbing or tingling of the extremities
  • Sleep disturbances
  • Urinary problems

Any combination of these symptoms can also suggest the presence of other serious illnesses, such as:

  • Hypothyroidism
  • Sleep apnea
  • Rheumatoid arthritis
  • Lupus
  • Malignancy

Another reason fibromyalgia is hard to diagnose is the tendency for groups of symptoms to occur together in fibromyalgia patients. But the groups will not be the same for everyone. So, not everyone with fibromyalgia will have all the symptoms described above.

And because the symptoms can suggest multiple diseases, doctors need to rule them out first as they look for an explanation.

Coexisting Conditions

Another problem with diagnosing fibromyalgia is that a patient could have other conditions at the same time as fibromyalgia.

For example, a person could have Lyme disease, arthritis, or obstructive sleep apnea -- all conditions that can mimic fibromyalgia -- and also have fibromyalgia as a secondary condition.

Sometimes health professionals, especially those unfamiliar with fibromyalgia, limit themselves to treating one disease and do not check whether fibromyalgia could be contributing to the symptoms.

Diagnosing Fibromyalgia

Fibromyalgia is usually diagnosed by physical exam. People with fibromyalgia have a history of widespread pain with no evident cause that lasts three months or more. There are usually multiple tender points on the patient's body that are identified by applying pressure to these spots.

There is a blood test to help diagnose fibromyalgia. The test -- called FM/a -- identifies markers produced by immune system blood cells in people with fibromyalgia. Ask your doctor if the FM/a test is right for you. 

 

Getting a Diagnosis of Fibromyalgia

There are several important things to keep in mind when thinking about chronic, widespread pain:

  • Ongoing chronic pain that is widespread is not in your head. Pain is real and needs to be evaluated.
  • Keeping a journal of your pain symptoms will make it easier to talk with your doctor about the pain. It will help make sure the doctor has the information needed to properly evaluate your condition.
  • Consultation with a pain specialist (usually a rheumatologist) who is familiar with fibromyalgia can help diagnose or rule out fibromyalgia as a cause of the pain.
  • There are effective treatments for fibromyalgia that can reverse the debilitating effect of the pain and greatly improve a person's quality of life.

 

WebMD Medical Reference

Reviewed by David Zelman, MD on June 06, 2013

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