• Michael Lenz

Do I have fibromyalgia? Diagnosis

Updated: Aug 11

Do I have fibromyalgia? Let’s first look at how medical doctors make a diagnosis. Often there is more than one chief complaint. There are more than an organ specific issue. You have migraines and headaches but also may have ashiness and pain in other parts of the body are sore. You might be afraid that the doctor will think that you are a hypochondriac.

It is important to write this down before you go to the doctor to be ready to share them with him or her. Doctors have limited time and the easier you make their job the better off you both will be.

After the chief complain(s) is the the history of present illness, also known as the HPI. When did your pain start. For some this has been your whole life. It may have started as colic as a newborn that resolved after a few months only to return years later in the form of abdominal pain. There is a chapter in my book on pediatric fibro. In adolescence it may have been painful periods, migraines, neck or back pain. There may have been a car accident causing problems.

After college your activity may have lessened leading to the unveiling of you fibro.

Maybe the history was where you were doing well until pregnancy and then were told you shouldn’t really exercise that much. Maybe you gained a lot more weight during your pregnancy and were never able to get back to your pre pregnancy weight.

What treatments did you go through. Maybe your IBS and migraines were treated. Maybe you were told you had bulging discs and failed attempts of epidurals.

What are the aggravating and alleviating factors. If you have chest pain and walk into the emergency department and let them know you are having chest pain and are diabetic you will get rapid attention. It is so important to get a heart attack treated quickly. How dod I know if it is a heart attack or more fibromyalgia like pain. Many with fibro have chest pain may notice it more when you are sitting or at work or maybe at home depending on how much they enjoy their work environment and how stressful the home environment is. You may may notice a difference based on the day of the week based on stress.

Some may feel more pain after exercise but not during. If you have fibro you likely will feel better in the middle of exercise but then start to notice the pain after you exercise or maybe a day or 2 after, especially if you were much more active..

What about headaches? Migraines are severe and last from hours up to 3 days and then feel better in between. Brain cancer doesn’t wax and wane like this. Another common pain is radicular or herniated disk pain. The pain of nerve compression at the spinal cord give typical pain in the dermatome, which is greek for the section of skin that nerve gives sensation to. Cervical spine 5 area will give specific pain on the side of the herniation and wouldn’t give pain in the leg. If you have bilateral upper and lower extremity burning pain, multiple simultaneous radicular pain is highly unlikely to explain the pain. This incongruence would leave the physician strongly considering the patient is a type of hypochondriac if they are unaware of fibromyalgia.

What about IBS. Abdominal intestinal system symptoms have different clues to their origins. Patients with IBS are less likely to lose weight or have blood in their stool. In fact many tend to have gained weight overtime. Those with cancer tend to have alarm clues such as weight loss, loss of appetite, and bloody stools. IBS , like other fibro systems tend to wax and wane depending on stressors. It may be better in the summer and then worse during the school year. It may have been better when you were actively on your sports team exercising at a high level daily but then worsen when the season comes to an end.

Can you have fibro with other conditions like rheumatoid arthritis or Crohn’s disease with fibro and IBS? You definitely can. They often coexist.

In conclusion, your origin story of fibromyalgia is so important to help your doctor make the diagnosis and offers you as a patient a better understanding. The blindfold of misunderstood fibro gets removed.


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