Why is fibromyalgia so frequently dismissed or misdiagnosed?
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Honor Society of Nursing (STTI) answered:The reasons that fibromyalgia is frequently dismissed or misdiagnosed are complex. For starters, there is no blood or imaging test (such as an X-ray or MRI) that doctors can use to diagnose fibromyalgia. Doctors must determine whether a patient has fibromyalgia based on his or her symptoms. Yet fibromyalgia symptoms such as pain and fatigue mimic those of many other conditions, such as arthritis and depression. For these reasons, a patient with fibromyalgia may see several physicians before he or she is accurately diagnosed.
The reasons that fibromyalgia is frequently dismissed or misdiagnosed are complex. For starters, there is no blood or imaging test (such as an X-ray or MRI) that doctors can use to diagnose fibromyalgia. Doctors must determine whether a... More -
Celeste Cooper answered:The short answer is fibromyalgia is frequently dismissed because of inadequate information, education and awareness in the medical field.
Fibromyalgia can be misdiagnosed when a thorough history and physical are not completed. The preliminary proposed diagnostic criteria for FM completely disregards what clinicians have become comfortable with, the tender point count. While I agree that tender points may really be trigger points, and one can have pain in other areas and still have fibromyalgia, I fear this new criteria will give permission to leave out one of the most valuable tools for diagnosis, “The physical exam.” If this criteria is allowed to stand with the American College of Rheumatology, it will only cause further misdiagnosis of FM and lead us down another decade of inappropriate treatment. The proposed criteria only consider a check list of widespread pain, and symptoms of various comorbid conditions (all jumbled up together as primary to FM, when they are not), and primary symptoms of fibromyalgia which will be more confusing to the treating physician and the patient.
Research continues to point fibromyalgia in the direction of a neurological disorder with centralization of pain, which is exacerbated by peripheral pain stimulus. Myofascial pain syndrome, AKA chronic myofascial pain, from knotted up pieces of muscle fiber (trigger points) has been found in 9 of 10 FM patients and is a peripheral pain stimulus. In addition, comorbid conditions, such as, TMJ, restless leg syndrome, migraine, interstitial cystitis, all have this myofascial component so in essence FMers deal with a wheel spinning out of control, sending off pain impulses that keep us ramped up and ready for disaster.
Only better diagnostic criteria and education is going to solve this problem.
All blogs, posts and answers are based on the work in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN, and Jeff Miller, PhD. 2010, Vermont: Healing Arts press and are not meant to replace medical advice. http://www.thesethree.com
Find out more about this book: Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofa...
The short answer is fibromyalgia is frequently dismissed because of inadequate information, education and awareness in the medical field. Fibromyalgia can be misdiagnosed when a thorough history and physical are not completed. The preliminary... More -
Johns Hopkins Medicine answered:Fibromyalgia is extremely difficult to diagnose because the medical community still does not definitively know what causes it. It remains a common, chronic, generalized pain syndrome of unknown origin. The generalized aches, pain, and stiffness combined with the diverse symptoms can make fibromyalgia simultaneously one of the most disabling and least understood illnesses.
Additionally, doctors within the medical community do not agree on an objective method of diagnosis.
In 1990, the American College of Rheumatology developed diagnostic criteria for fibromyalgia. They concluded that fibromyalgia is diagnosed by identifying certain trigger points on the body. It is important to understand that fibromyalgia is a diagnosis of exclusion; meaning that doctors try to rule out anything else that may be causing the pain.
If the patient reports experiencing whole body pain for at least three months, the physician may conclude (after ruling out other possible conditions) that fibromyalgia is the culprit. To confirm the diagnosis, pressure is applied to 18 tender points - points where tendons attach to muscle. If the patient affirms pain definitively in at least 11 of 18 points, fibromyalgia can be diagnosed.
There are some in the medical community who disagree with this type of diagnostic criteria.
A combination of all these factors makes it easy for doctors to miss the diagnosis of fibromyalgia.
Fibromyalgia is extremely difficult to diagnose because the medical community still does not definitively know what causes it. It remains a common, chronic, generalized pain syndrome of unknown origin. The generalized aches, pain, and stiffness... More
