Fibromyalgia: What You Need to Know

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.

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 Diseases

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.

Overly Specific Diagnostic Criteria

Until recently, the accepted criteria for a formal diagnosis of fibromyalgia, established in 1990 by the American College of Rheumatology, included:

• A history of widespread pain with no evident cause that lasts three months or more
• Identification of at least 11 out of 18 tender points on the patient's body

Tender points are locations on the body that may be unusually sensitive to light pressure. To identify tender points, the doctor applies pressure to the spot to gauge the patient's reaction.