Fibromyalgia, Difficult to Diagnose

Over the past four to 18 years of operating a chiropractic practice in Merritt, I have been treating an increasing number of patients with a broad array of symptoms that fulfill the criteria of a syndrome called “fibromyalgia”. Patients with this syndrome are becoming more numerous every year. This is partly due to the fact that more health care practitioners are becoming educated on what exactly it is and making the diagnosis more frequently.

The average fibromyalgia patient suffers for years and spends thousands of dollars on medical or alternative therapies before receiving an accurate diagnosis. Typically, patients receive an inaccurate diagnosis, resulting in more than half of them undergoing unnecessary surgery. Have patience with your health care practitioners; it is very difficult for an accurate diagnosis to be made. Patients can come in with different symptoms every visit, which often do not seem related to each other. These can vary from headaches, irritable bladder/bowel, dysmenorrhea, cold sensitivity, restless legs, numbness or tingling, exercise intolerance, weakness, sleep problems, chronic fatigue, morning stiffness, multiple tender points, blurred vision, falling, itching, pelvic pain, hearing loss, to muscle aches and pains. The most commonly described symptom is pain. This is by no means an all-inclusive list of symptoms that a fibromyalgia patient may experience, as there are many more. To make things even more confusing, the signs and symptoms can, and frequently do, fluctuate from hour to hour and day to day.

It is important to understand that fibromyalgia is not a catchall “wastebasket” diagnosis. It is a specific, chronic, non-degenerative, non-progressive; non-inflammatory, truly systemic pain condition –a true SYNDROME. It is not a DISEASE. A disease has a known cause and well-understood mechanism for producing symptoms. For example, rheumatoid arthritis is a specific type of arthritis that can be distinguished from other types of arthritis through x-rays, blood tests, and specific signs/symptoms. We know a lot about how it happens and there are specific forms of treatment that often help. In comparison, fibromyalgia is a SYNDROME. It has a specific set of symptoms patients’ experience and signs that the health care practitioner can identify, all occurring at once.  There are no blood tests or other laboratory tests that allow an accurate diagnosis.

To be diagnosed with fibromyalgia, your health care practitioner must be able to identify 11 of 18 specific points on the body that are abnormally tender. The official definition requires that the tender points must be present in all four quadrants of the body –the upper right, upper left, lower right, and lower left parts of the body. You must also have widespread, pretty much continuous pain and some of the previously mentioned symptoms for at least three months.

Patients may on occasion be improperly diagnosed with fibromyalgia. For example, patients may have pain only on one side of the body and not necessarily in the upper and lower limbs. Unfortunately, some patients may be given a diagnosis of fibromyalgia by a health care practitioner simply because he or she cannot figure out what is really wrong.  The safest bet is to take the initiative to become informed on the subject so that you can work with your healthcare practitioners in determining what treatment route to pursue. Personally, I have found that regular chiropractic treatment can help decrease the severity of the ongoing fibromyalgia symptoms. If you have any questions about how a chiropractor can help with your fibromyalgia, or any other physical problem, please contact your health care provider or chiropractor.