Fibromyalgia Diagnosis

by Karen Lee Richards Patient Advocate

by Karen Lee Richards, ChronicPainConnection Expert

Fibromyalgia (FM) must be diagnosed by a qualified physician who is familiar with the illness and has experience diagnosing it. The specialists who most often diagnose and treat fibromyalgia are rheumatologists.

In 1990, the American College of Rheumatology established the diagnostic criteria for fibromyalgia. Both of the following must be present:

  • A history of widespread pain in all four quadrants of the body for a minimum duration of three months, and

  • Pain in at least 11 of 18 designated tender points when four kilograms (about 10 pounds) of pressure are applied. (See a diagram of the fibromyalgia tender points here.)

    Although the American College of Rheumatology does not classify fibromyalgia as a diagnosis of exclusion, there are several other illnesses that have similar symptoms and sometimes occur along with FM. Therefore, it is important that the doctor test for certain comorbid conditions as well. Which tests may be necessary will depend upon the individual patient's symptoms and medical history. Possible overlapping conditions may include:

  • Migraine disease

  • Restless legs syndrome

  • Chronic fatigue syndrome (myalgic encephalopathy)

  • Irritable bowel syndrome

  • Lupus

  • Multiple sclerosis

  • Hypothyroidism

  • Temporomandibular joint disorder (TMJ)

  • Chiari malformation

  • Intermittent cervical cord compression

  • Cervical stenosis

  • Polymyalgia rheumatica

  • Sleep apnea

  • Raynaud's syndrome

  • Sjogren's disease

  • Myofascial pain syndrome

  • Depression

  • Osteoporosis

  • Multiple chemical sensitivity

  • Rheumatoid arthritis

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.