Tips for Getting a Fibromyalgia Diagnosis

by Ginger Vieira Health Writer & Patient Advocate

The process of getting a fibromyalgia diagnosis — and getting the right treatment and medication to help reduce your pain — can take a while. A long while. At least two years, in fact, according to the FibroCenter. The problem is that there is no actual test to diagnose fibromyalgia. Instead, it’s usually diagnosed by ruling out all the other possibilities.

Here are the steps you’ll likely (and should) need to take to reach a fibromyalgia diagnosis.

Referral definition.

Get a referral to a rheumatologist

The type of doctor that traditionally diagnoses fibromyalgia is a rheumatologist. A rheumatologist focuses on the treatment of conditions in the musculoskeletal system — the joints, muscles, and bones that are generally suffering from pain, swelling, stiffness, or deformity. Fibromyalgia is assessed first by assessing pain in the “18 spots".

Woman journaling her symptoms.

Document your symptoms

Trying to think of all your symptoms when you’re actually sitting in the doctor’s office is overwhelming. Plus, there might be symptoms you’ve thought of as separate issue that are in fact part of your overall condition. And when they check the classic “18 tender spots” of fibromyalgia pain, you might not be feeling pain in all of those area that day. Keep a simple diary of your symptoms so you’re prepared.

Man holding wrist from pain.

Get tested for rheumatoid arthritis

The biggest difference between rheumatoid arthritis (RA) and fibromyalgia is the swelling. Early RA symptoms include stiffness, pain, and swelling in the smaller joints of the hands and feet that lasts for more than 30 minutes, usually in the morning. Those symptoms can gradually spread to the larger joints, like elbows, ankles, hips, knees, and shoulders. There are actually a half dozen blood-tests that can indicate RA, so it’s usually easy to identify or rule out.

MRI brain scan.

Get tested for multiple sclerosis

Like fibromyalgia, multiple sclerosis (MS) symptoms include pain in various areas of the body, headaches, tingling in the legs and hands, insomnia, and fatigue — but MS also brings with it a huge number of other symptoms. The first test to undergo is an MRI of the brain and the spine. The MRI will reveal inflammation and lesions, which can change week-to-week. The number of lesions does not correlate directly with the severity of symptoms or the progression of the disease.

Lyme disease blood test vial.

Get tested for Lyme disease

Lyme disease is transmitted by a tick bite. Symptoms include pain throughout the body, severe fatigue, headache, fever, and more. While there is a blood-test for the disease, it isn’t 100 percent perfect. Treatment for Lyme isn’t perfect either, but the sooner you start antibiotics, the better your chances of preventing severe symptoms.

Doctor spelling out neuropathy on clipboard.

Get tested for neuropathy (if you have diabetes)

If you have diabetes and you tell your doctor your legs are tingling, he or she will test you for neuropathy first. So many doctors are skeptical of fibromyalgia being a real condition that your tingling legs may go ignored for years even if that neuropathy test shows zero nerve damage. Neuropathy symptoms include tingling, burning, loss of balance, weakness, and wounds or blisters that don’t heal well.

Throat sore from swollen thyroids.

Get tested for hypothyroidism

Hypothyroidism is an autoimmune condition causing the thyroid gland to under-produce critical hormones for daily function. Common symptoms include severe fatigue, hair loss, weight gain, mood changes, swelling of the thyroid gland (located in your neck), and more. Fortunately, the blood tests to identify the condition are generally accurate, and while the hormonal treatment isn’t perfect, it can ease most of the symptoms significantly.

Gluten free spelled out in grain.

Try going gluten-free for one month

Going gluten-free is so trendy these days that it’s easy to dismiss, but the widespread inflammation caused by gluten can cause a tremendous variety of symptoms that vary greatly from one person to the next. Cutting gluten out of your diet for 30 days will definitely reveal if an allergy to gluten is causing your severest symptoms. For many, some symptoms improve within days of removing gluten-containing foods.

Woman having neck adjusted by chiropractor.

Be very careful if you try a chiropractor or physical therapist

It’s very easy to find yourself at the chiropractor on a weekly basis getting adjustments in your back and neck, but if you do have fibromyalgia, these adjustments can often make things worse over time. If it’s giving you genuine relief, that’s wonderful, but if you’re feeling any hesitation about whether it’s helping or hurting, consider taking a break from the appointments and see how you feel. The same goes for physical therapy treatments.

Handful of pills.

Discuss with your doctor: muscle relaxants and/or antidepressants

If you’ve managed to work through the many required steps to rule everything out and you’ve found a worthwhile doctor who understands how real your symptoms are, one of the next steps is to start a medication for some immediate relief. For many, muscle relaxants or antidepressants can be incredibly effective in easing pain and helping with other symptoms like insomnia and brain fog. Ask your rheumatologist about one or the other to get started.

Ginger Vieira
Meet Our Writer
Ginger Vieira

Ginger Vieira has lived with Type 1 diabetes and Celiac disease since 1999, and fibromyalgia since 2014. She is the author of Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, and Your Diabetes Science Experiment. Ginger contributes regularly for Diabetes Strong, Healthline, HealthCentral, DiabetesDaily, EverydayHealth, and her YouTube channel. Her background includes a B.S. in professional writing, certifications in cognitive coaching, Ashtanga yoga, and personal training, with several records in drug-free powerlifting. She lives in Vermont with her husband, their two daughters, and their dog, Pedro.