The path to a fibromyalgia diagnosis is often long and uncertain, with many people waiting an average of five years. Throughout this process, they often face the challenge of seeing whether symptoms persist or worsen. Doctors may suspect or misdiagnose other conditions before identifying fibromyalgia. For those with multiple chronic conditions, pinpointing whether fibromyalgia or another condition is causing pain and symptoms becomes even more complicated.

Previously, many doctors denied the validity of fibromyalgia as a diagnosis. This is because it cannot be detected by tests, and researchers still do not know how it develops. Physicians sometimes insisted fibromyalgia symptoms were purely psychological. Fibromyalgia is more widely recognized now, and there are guidelines for its diagnosis and treatment.

How Is Fibromyalgia Diagnosed?

There is no one conclusive test that proves a person has fibromyalgia. While fibromyalgia symptoms vary from person to person, certain core symptoms must be present for doctors to consider a fibromyalgia diagnosis. Severity and duration of symptoms are also important.

There are three main criteria, all of which must be present to diagnose fibromyalgia:

• You must have symptoms of widespread pain, which you can feel on both sides of the body and in areas on both your upper and lower body. You must also have fatigue and cognitive issues and wake up feeling tired.
• Your symptoms must have lasted at least three months at a similar severity.
• All other possible causes and conditions must be ruled out.

Tests and What They Show

Some tests can provide support for a fibromyalgia diagnosis, while others are performed to rule out other conditions.

Medical History

Your doctor will take a thorough history, asking for specific details about pain and other symptoms over time. They will likely ask about your family medical history, any other conditions you’ve had, and possible exposures to toxins or infections. A clear picture may emerge from the medical history to help your doctor assess risk factors for fibromyalgia or rule out other conditions.

Physical Exam

Your doctor will carefully examine you, checking for tender points and any other source of pain. They will want to see if the pain you feel is considered widespread, meaning it is located in several places and on both sides of the body. The results of the physical exam may suggest fibromyalgia or another condition.

Ruling Out Other Conditions

Dozens of other conditions can produce fibromyalgia-like symptoms, such as fatigue and chronic pain. These must be ruled out to confirm fibromyalgia. The process of ruling out similar conditions is referred to as differential diagnosis. Conditions that may resemble fibromyalgia include:

• Hypothyroidism (low thyroid hormones)
• Polymyalgia rheumatica
• Depression
• Lupus
• Spondylitis
• Sjögren’s syndrome
• Multiple sclerosis
• Myasthenia gravis
• Rheumatoid arthritis

Your doctor may be able to rule out many of these conditions quickly based on your medical and family history or simple blood tests. Other disorders may require time and repeated tests before they can be confirmed or ruled out. The presence of other diseases in addition to fibromyalgia may complicate this process and eventually result in multiple diagnoses.

Blood Tests

Blood tests cannot prove fibromyalgia, but they can rule out many other conditions. For example, hypothyroid tests will show abnormally low levels of thyroid hormones.

Most autoimmune conditions will show high levels of inflammatory proteins and autoantibodies, which are proteins made by the immune system that attack the body’s tissues. However, this does not mean your doctor will always test your blood for autoimmune conditions. Your doctor will decide which blood tests to order based on your symptoms. If all your blood tests are normal, a diagnosis of fibromyalgia is more likely.

Imaging Scans

If your doctor suspects you have a condition that can damage the joints, like rheumatoid arthritis, they may order X-ray, computed tomography (CT), or magnetic resonance imaging (MRI) scans. Fibromyalgia does not cause joint damage and will not show signs on these scans.

What Is the Prognosis for Fibromyalgia?

Fibromyalgia is a chronic condition, but symptoms may come and go. There may be significant periods of remission. Fibromyalgia is not life-threatening, and it does not shorten a person’s life span. There is no cure for fibromyalgia, but it can be treated. Read more about fibromyalgia treatments.

You Are Not Alone

On MyFibroTeam, the social network for people with fibromyalgia and their loved ones, more than 289,000 members come together to ask questions, give advice, and share their stories with others who understand life with fibromyalgia.