Conditions with Similar Symptoms
Between 10% and 30% of all doctor's office visits are due to symptoms that resemble those of fibromyalgia, including fatigue, malaise, and widespread muscle pain. Because no laboratory test can confirm fibromyalgia, doctors will usually first test for similar conditions. A diagnosis of many of the disorders below may not always rule out fibromyalgia, because several conditions may overlap or coexist with fibromyalgia, and have similar symptoms. Like fibromyalgia, a number of them also cannot easily be diagnosed. It is not clear whether these conditions cause fibromyalgia, are risk factors for the disorder, have causes in common with fibromyalgia, or have no relationship at all with it.
Chronic Fatigue Syndrome. There is a significant overlap between fibromyalgia and chronic fatigue syndrome (CFS). As with fibromyalgia, the cause of CFS is unknown. A doctor can diagnose either disorder based only on symptoms reported by the patient. The two disorders share most of the same symptoms. They are also treated almost identically. The main differences are:
- Pain with tender points is the primary symptom in fibromyalgia. Some patients with CFS exhibit similar tender pressure points; however, their muscle pain is less prominent.
- Fatigue is the main symptom in CFS. It is severe, is not caused by excessive work or exercise, and is not relieved by rest or sleep.
Some doctors believe that fibromyalgia is simply an extreme type of chronic fatigue syndrome. Physical evidence, however, indicates that the two disorders are distinct, and each has its own treatments.
Myofascial Pain Syndrome. Myofascial pain syndrome can be confused with fibromyalgia and may also accompany it. Unlike fibromyalgia, myofascial pain tends to occur in trigger points, as opposed to tender points, and typically there is no widespread, generalized pain. Trigger-point pain occurs in tight muscles, and when the doctor presses on these points, the patient may experience a muscle twitch. Unlike tender points, trigger points are often small lumps, about the size of a pencil eraser.
Review Date: 12/27/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.