Who Diagnoses Fibromyalgia?

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Who diagnoses fibromyalgia? While fibromyalgia has been around for centuries, but has only gained recognition as a bona fide medical condition in the last few years, thanks to new research linking the condition to actual disease processes instead of obscure complaints.

According to the National Fibromyalgia Syndrome Association, about 12 million to 20 million people in the USA suffer from fibromyalgia, which today is classified as a rheumatologic neurologic disease. About 90 percent of fibromyalgia patients in the USA are women, and most patients develop the disease later in life, although it can develop during the teenage years.

Fibromyalgia has not always been considered a disease, but has been labeled as depression or as a psychological problem, and treated as such. Many times addictive medications such as opioids are prescribed along with anti-depressants, leading some to speculate that fibromyalgia was a mental illness.

Symptoms of the disease include fatigue, waking unrefreshed, memory or thought problems, and no other health problems that could explain the symptoms. Also suspect are pain points that last longer than a week in several of 18 parts of the body.

Even though in the 1800s a Scottish surgeon, William Balfour, discovered nodules on connective tissue and theorized that inflammation was the cause of these pain points, the disease was not recognized as valid or physically significant until relatively recently.

By 1880 an American neurologist, George William Beard, introduced terms such as myelasthenia and neurasthenia to describe overall pain coupled with extreme fatigue and coping problems, but still the condition was not classified under a single umbrella.

Even until 1975 terms such as fibrosis, muscle hardening and myogelosis were used to describe conditions now accepted as part of the fibromyalgia family of pain symptoms. As of 1968 studies began to show that the disease was more common in women who complained about general stiffness and fatigue, headaches, colitis and, of course as a side effect to pain and poor sleep, leading to the assumption that mainly women suffer from it. Singular symptoms meant a patient would be treated by specialists in the areas where the symptoms were most problematic.

As a result of these various conditions, a number of specialty physicians were involved in the diagnosis of the disease, from those working in connective tissue problems to osteo problems to psychological problems to colorectal diseases.

And because of the connective tissue discomfort, fibromyalgia was lumped in with chronic diseases such as rheumatoid arthritis, and patients frequently were referred to these specialists when they were attempting to be diagnosed.

Major progress in recognizing fibromyalgia as condition to itself was made in 1990 when the American College of Rheumatology established official criteria to be used to diagnose the newly named condition that includes widespread pain and tenderness in 11 out of 18 specific tender points.

Then, in 2014 a paper was published in the online edition of the National Fibromyalgia & Chronic Pain web site written by Bruce S. Gillis, MD, MPH, a medical research physician who was a part of a team at the University of Illinois College of medicine in Chicago.

Gillis was able to prove that fibromyalgia patients suffer from a depressed immune system. He did this by using the American College of Rheumatology 1990 diagnostic criteria. Through the use of that test, he and his team were able to prove that there is a specific pathway in fibromyalgia that defines it as an immunologic medical disorder that relates to the production of protein molecules called cytokines.

Cytokines can be found in a blood test called the FM/a® Test. Cytokine are a category of small proteins that are important in cell signaling. They have an impact on the immune system and on other surrounding cells.

So, who can diagnose the condition today?

The creation of the FM/a® Test paired with the 1990 list of criteria has enabled doctors to perform tests that are capable of making an accurate fibromyalgia diagnosis.

Today, even general practitioners can diagnose with accuracy whether a patient is suffering from fibromyalgia or another disease. They can look at a patient’s relevant symptoms instead of relying on purely pain points during a physical examination, follow the 1990 guidelines and conduct the blood test.

Doctors can also order X-rays to rule out other health problems.

Other diseases that can look like fibromyalgia include hypothyroidism, polymyalgia rheumatica, rheumatoid arthritis or lupus.

Doctors of diverse specialties may also look for family histories of fibromyalgia to aid them in their diagnosis.