Diagnosing Fibromyalgia

NYU Langone rheumatologists—specialists who treat conditions that cause pain and swelling in muscles, joints, and tendons—are experienced in recognizing the symptoms of fibromyalgia. People with this condition generally have widespread and chronic pain and tenderness in the muscles throughout the body.

Fibromyalgia is a syndrome—that is, it’s a set of symptoms that occur together and indicate a specific condition. The cause of fibromyalgia is unknown. One theory is that people with the condition have reduced levels of a neurotransmitter, or brain chemical, called serotonin. This decrease in serotonin is thought to increase sensitivity to pain.

Symptoms of Fibromyalgia

Symptoms of fibromyalgia may appear suddenly after an illness, physical trauma, or significant psychological stress. In some people, however, fibromyalgia symptoms appear gradually, and a specific event is not believed to trigger pain and fatigue.

The primary symptom of fibromyalgia is intense aching that can occur anywhere in the body. In particular, people with fibromyalgia often experience pain and tenderness in the neck and back. People who have fibromyalgia may feel chronically fatigued, because pain interferes with sleep. Sleep deprivation also leads to decreased tolerance to pain.

People with fibromyalgia are more likely than the general public to have symptoms of other chronic conditions, such as irritable bowel syndrome, which can cause abdominal pain, cramps, and constipation or diarrhea. People with fibromyalgia may also have frequent migraines, depression, or interstitial cystitis, an inflammatory condition of the bladder that causes discomfort and the frequent need to urinate.

Fibromyalgia occurs most often in women older than age 40, especially in people who have a family history of the condition. People who have other rheumatic conditions—such as rheumatoid arthritis or systemic lupus erythematosus, which can cause swelling or stiffness that affects muscles, bones, and joints—are at increased risk of developing fibromyalgia.

Physical Exam

There is currently no single test to confirm a diagnosis of fibromyalgia. NYU Langone doctors ask detailed questions about your medical history and perform a comprehensive physical exam to evaluate your condition.

Your doctor considers the location and type of pain you’re experiencing, as well as any other symptoms. He or she may look for joint swelling to rule out an inflammatory disorder, such as rheumatoid arthritis, and feel your muscles and tendons to check for specific areas of sensitivity or pain.

Blood Tests

Doctors may also order blood tests to find out if your symptoms are due to a condition other than fibromyalgia, such as rheumatoid arthritis, systemic lupus erythematosus, or Sjogren’s syndrome.

Additional blood tests can help to rule out common causes of fatigue, such as hypothyroidism, which is an underactive thyroid gland. Anemia, which is caused by low levels of red blood cells, can also cause fatigue, as can mononucleosis, which is a viral infection.

Sleep apnea can cause symptoms that are very similar to those associated with fibromyalgia. If your doctor suspects that you have sleep apnea, he or she may recommend a sleep study, which is an overnight test that assesses how well you sleep. The results of this assessment can help doctors to diagnose a sleep disorder.

If the pain and inflammation you’re experiencing cannot be attributed to another condition, your doctor may diagnose fibromyalgia.