You have realized that something is not quite right with your health. You have been experiencing pain throughout your body but you can’t seem to pin point the source of the pain. You feel stiff and sore in the mornings, your mind feels foggy, you are unusually tired and you have a whole host of symptoms that you just can’t explain. The Fibromyalgia commercials explain symptoms that sound scarily familiar so you have made an appointment with your doctor, but what should you expect? Can your doctor just examine you and tell you what is wrong or will there be tests? If there are tests, how many will there be? Will those tests be painful, expensive or time consuming? Knowing what to expect before you walk into the doctor’s office will help take some of the fear out of getting a diagnosis.
Fibromyalgia is known as the great imitator because it mimics so many other diseases. While the exact cause of Fibromyalgia is not yet fully understood, it is being studied by many scientists to determine the cause and to develop more effective treatments.
Your doctor will want to examine you first. You will be asked to provide your full medical history, as well as whether or not anyone else in your family has ever experienced the same symptoms. You will also be asked many questions about your pain; where it hurts, how badly it hurts on a scale of 0 to 19 and when you hurt the worst, but it is unlikely that you will receive a diagnosis during your first visit and here is the reason for that, In May of 2010 The American College of Rheumatology developed new guidelines for diagnosing Fibromyalgia. Because Fibromyalgia mimics so many other diseases, every other disease must be ruled out first.
The new guidelines include The Widespread Pain Index (WPI) and The Symptom Severity Scale Score (SS Scale Score). In order for Fibromyalgia to be a possible diagnosis, pain must be present for at least three months. The WPI lists 19 areas of the body that were painful in the week prior to your doctor appointment. You will be asked to assign a pain number to each of the 19 areas using a pain scale of 0-19. This pain scale is different because many Fibromyalgia patients do not find the 0-10 pain scale sufficient to describe their pain.
The Symptom Severity Scale (SS Scale Score) ranks specific symptoms found in Fibromyalgia using a scoring system of 0-3. The SS Scale Score measures the severity of Somatic symptoms. These are physical symptoms. Some of these symptoms include; fatigue (unusual tiredness), muscle pain, fogginess (being unable to concentrate), headaches, Irritable Bowel Syndrome, numbness and tingling, muscle spasms, muscle weakness, hives, seizures, insomnia, Raynaud’s phenomenon. This is only a partial list of the somatic symptoms. There are 41 symptoms on the SS Scale.
In order to receive a Fibromyalgia diagnosis, every other test must come back negative for another disease and under current guidelines, you must have EITHER a WPI of at least 7 and an SS scale score of no less than 5 OR a WPI of 3 to 6 and an SS scale score of at least 9.
Once you have received a Fibromyalgia diagnosis, you will likely be sent to both a Rheumatologist and a Neurologist for further treatment. Fibromyalgia is difficult to diagnose and to treat. Because of this, the testing must be stringent in order to be certain that you are not experiencing something with similar symptoms such as Lyme disease, Multiple Sclerosis or Lupus.
Determining if you have Fibromyalgia is a long, difficult and sometimes frustrating process but knowing what to expect before you start this journey will help you to be prepared and patient. If you believe you may have Fibromyalgia, call your doctor and then educate yourself. There is a great deal to this disease and you must become your own advocate. There are many, many resources online that will help guide you through the maze of doctors and information so that you can live a life with less pain.
For more information on Fibromyalgia symptoms, treatments and diagnosis go to the following websites: http://www.nfra.net (National Fibromyalgia Research Association) http://www.americanpainsociety.org and The American College of Rheumatology at http://www.rheumatology.org
