Diagnosing fibromyalgia

If you think you have fibromyalgia, visit your GP. Diagnosing fibromyalgia can be difficult, as there is no specific test that can diagnose the condition.

The symptoms of fibromyalgia can be varied and similar to those of several other conditions. Your GP will diagnose fibromyalgia based on your symptoms and by ruling out other conditions that could be causing them.

You will be asked about how your symptoms are affecting your daily life and examined to check your body for any visible signs of other conditions. For example, swollen joints would suggest rheumatoid arthritis, rather than fibromyalgia.

Ruling out other conditions

If your GP thinks you may have fibromyalgia, they will first have to rule out all other conditions that could be causing your symptoms. These conditions include:

• chronic fatigue syndrome (also known as myalgic encephalomyelitis, or ME) – a condition that causes long-term tiredness
• rheumatoid arthritis – a condition that causes pain and inflammation (swelling) in the joints
• multiple sclerosis (MS) – a condition of the central nervous system (the brain and spinal cord) that affects movement and balance

You may have blood tests, X-rays and other scans to rule out these and any other condition with symptoms similar to fibromyalgia. If you are found to have another condition, you could still have fibromyalgia as well.

Diagnosing fibromyalgia

Once all other conditions have been considered or ruled out, there are two criteria that can be used to confirm a diagnosis of fibromyalgia. If your symptoms fit within these criteria, it is likely you will be diagnosed with fibromyalgia.

Criteria for diagnosing fibromyalgia are:

• widespread pain for more than three months on both the left and right sides of your body, above and below your waist
• pain in at least 11 of the 18 ‘tender points’ when they are pressed

Tender points

These are the areas on your body where pain is likely to be at its worst. There are tender points at the back of your neck, above each of your shoulder blades and the inside of your elbows. Your GP may also press other areas that are not tender points, to compare how much more painful the tender points are.

Additional conditions

It is also possible to have other conditions alongside your fibromyalgia. For example:

• depression (long-term feelings of extreme sadness)
• anxiety (constant feelings of worry)
• irritable bowel syndrome (a condition that affects the digestive system) 

If your symptoms suggest you have another condition as well, you may need further tests to diagnose these. Identifying all possible conditions will help to guide your treatment.