Chiropractic Examination Fibromyalgia Diagnosis

A fibromyalgia diagnosis involves the process of eliminating other disorders and conditions with similar symptoms. It is not easy to diagnose fibromyalgia. There is no common exam or test that a doctor can use to diagnose fibromyalgia definitively. The elimination process is utilized because of several other conditions with similar symptoms. These include:

• Rheumatoid arthritis
• Chronic fatigue syndrome
• Lupus

It can take some time when an individual notices symptoms and is diagnosed with fibromyalgia, which can be frustrating. Doctors must become detectives, working hard to find the right cause of pain and other symptoms. Developing the right diagnosis is necessary to create an optimal treatment plan.

Fibromyalgia Diagnosis Criteria

• Pain and symptoms based on the total number of painful areas
• Fatigue
• Poor sleep
• Thinking problems
• Memory problems

In 2010, a published study updated the diagnostic criteria for fibromyalgia. The new criteria remove the emphasis on tender point examination. The 2010 criteria focus more on the widespread pain index or WPI. There is an item checklist about where and when an individual experiences pain. This index is combined with a symptom severity scale, and the result is a new way to classify and develop a fibromyalgia diagnosis.

Diagnostic Process

Medical History

A doctor will look at an individual’s complete medical history, asking about any other conditions present and family condition/disease history.

Symptoms Discussion

The most common questions a doctor asks are where it hurts, how it hurts, how long it hurts, etc. However, individuals should offer as much or add details of their symptoms as possible. Diagnosing fibromyalgia depends on reporting the symptoms, so it is important to be as specific and accurate as possible. A pain diary, which records all present symptoms, will make it easier to remember and share information with the doctor. An example is giving information on trouble sleeping, with a feeling of tiredness most of the time, and headache presentation.

Physical Examination

A doctor will palpate or apply light pressure around the tender points with the hands.

Other Tests

As previously stated, symptoms can be very similar to other conditions:

• Rheumatoid arthritis
• Hypothyroidism
• Ankylosing spondylitis

A doctor wants to rule out any other conditions so that they will order various tests. These tests are not to diagnose fibromyalgia but to eliminate other possible conditions. A doctor could order:

Anti-nuclear antibody – ANA test

Anti-nuclear antibodies are abnormal proteins that can be present in the blood if an individual has lupus. The doctor will want to see if the blood has these proteins to rule out lupus.

Blood count

A doctor can develop other possible causes for extreme fatigue, like anemia, by examining an individual’s blood count.

Erythrocyte sedimentation rate – ESR

An erythrocyte sedimentation rate test measures how quickly red blood cells fall to the bottom of a test tube. In individuals with a rheumatic disease like rheumatoid arthritis, the sedimentation rate is higher. The red blood cells fall quickly to the bottom. This suggests that there is inflammation in the body.

Rheumatoid factor – RF test

For individuals with an inflammatory condition like rheumatoid arthritis, a higher level of rheumatoid factor can be identified in the blood. A higher level of RF does not guarantee that the pain is caused by rheumatoid arthritis, but doing an RF test will help the doctor explore a possible RA diagnosis.

Thyroid tests

Thyroid tests will help a doctor rule out thyroid problems.

Final Note Fibromyalgia Diagnosis

Again, diagnosing fibromyalgia can take a while. A patient’s job is to be proactive in the diagnostic process. Be sure you understand what the results will tell and how that specific test will help determine the cause of the pain. If you don’t understand the results, ask questions until they make sense.

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InBody

Body Composition and Diabetes Connection

The body needs a balance of lean and fat mass to function properly/optimally and maintain overall health. The balance can be disrupted in overweight and obese individuals because of excess fat. Overweight individuals should improve body composition by reducing fat while maintaining or increasing lean body mass. Balanced body composition can reduce the risk of diabetes and other obesity-related disorders and positively affect metabolism. Metabolism is the breaking down of foods for energy and maintaining and repairing body structures.

The body breaks down the food nutrients/minerals into elemental components and directs them to where they need to go. Diabetes is a metabolic disorder that changes how the body uses nutrients, so the cells cannot utilize digested glucose for energy. Without insulin, glucose cannot enter the cells, so it lingers in the blood. It builds up when the glucose can’t make its way out of the blood. All the excess blood sugar can be converted to triglycerides and stored as fat. With increased fat mass, hormone imbalances or systemic inflammation can happen or progress. This increases the risk for other diseases or conditions. A buildup of fat and diabetes are associated with increased risk for:

• Heart attacks
• Nerve damage
• Eye problems
• Kidney disease
• Skin infections
• Stroke

Diabetes can even cause the immune system to become impaired. When combined with poor circulation to the extremities, the risk of wounds and infections can lead to amputation of the toes, foot/feet, or leg/s.

References

American College of Rheumatology. Fibromyalgia. 2013. http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Fibromyalgia/. Accessed December 5, 2014.

Living with Fibromyalgia: Mayo Clinic Proceedings. (June 2006) “Improvement in Fibromyalgia Symptoms With Acupuncture: Results of a Randomized Controlled Trial” www.sciencedirect.com/science/article/abs/pii/S0025619611617291

What Are Common Fibromyalgia Symptoms and How Does It Cause Back Pain?: Clinical Biomechanics. (July 2012) “Functional capacity, muscle strength and falls in women with fibromyalgia” www.sciencedirect.com/science/article/abs/pii/S0268003311003226