One of the biggest challenges that fibromyalgia faces are the difficulty of diagnosing at first place. There does have been a long history of generating skepticism and the tendency to think it’s all in the head. So, doctors need to understand and being able to identify the syndrome before treating it. It is important to have such methods of diagnosis that are reliable.
However, fibromyalgia has symptoms that seem similar to the other disease’s symptoms. The major symptom of fibromyalgia is widespread pain and it is also a symptom of many other diseases. Fibromyalgia is still a mystery that needs to be solved due to this it is difficult to know that patient has the condition. No simple test is available for the condition. We don’t know what to test for; all we do is to judge our symptoms. A wide variety of things often come along with fibromyalgia. So doctors have to rule those other things to properly diagnose fibromyalgia.
This syndrome hurts all over the body, and this is the major one. Unfortunately, it is not necessary that if one person says “it hurts all over” means the same thing as another person’s. The main focus of diagnosis is on tender points that arise with fibromyalgia. 18 tender points are connected with fibromyalgia. If the person is suffering from a widespread pain for three months and 11 out of 18 tender points are having pain, it means that the person is having this syndrome.
However, it has been always difficult to count all these tenders. It might be possible that a person experiences pain in 11 tender points in one examination, but he might experience pain in fewer tender points on next examination.
The criteria of tender points were developed for research studies, and it is still used for selecting purposes of candidates. However, the conditions might be strict for clinical diagnostic purposes. There might be some people who have fibromyalgia but don’t meet all the criteria. Besides, many general practitioners find it uncomfortable to do tender point count. More ways are being in research for a while.
In a newer research, two scores of combination from different scales are used to make a diagnosis. One is widespread pain index and the other is Symptom Severity Scale.
Widespread Pain Index
The points where the patient has encountered pain during the last week are 19 points of different areas of the body. The scoring of WPI is the total areas indicated by the patient. It is recommended to check that how the patient felt in last week and how he or she felt about treatments and medication to get an accurate score. Moreover, it is also recommended to check for other conditions you know you might suffer from that, which causes pain. Areas of consideration for the index are:
- Shoulder girdle (between neck and shoulder), left and right
- Upper arm, left and right
- Lower arm, left and right
- Upper and Lower Back
- Hips, left and right
- Upper leg, left and right
- Lower leg, left and right
- Jaw, left and right
Symptom Severity Scale
The three symptom areas of the patient are measured on this scale. It includes sleep that fails to give you rest, cognitive function issues and chronic fatigue. There is a ranking from 0 to 3 in four areas for a possible total of 12. Areas include fatigue, waking restless, cognitive issues and other symptoms. 0 is “no problem” and 3 refer to “severe”. You need to check how the patient felt previous week, just like WPI. Other symptoms are:
- Muscle Weakness
- Abdominal pain or cramps
- Numbness or tingling Muscle pain
- Irritable Bowel Syndrome
- Pain in upper abdomen
- Fatigue or tiredness
- Thinking or remembering problem
- Chest pain
- Unclear Vision
- Raynaud’s Syndrome
- Ringing in Ears
- Hair loss
- Frequent urination
- Bladder spasms
- Oral ulcers
- Loss or changes in taste
- Dry eyes
- Breath shortening
- Dry mouth
- Loss of Appetite
- Sun sensitivity
- Hearing difficulties
- Easy yellowing
Good results arrived from the new approach and it is considered that it will discover more than 88% of the cases. Some practitioners and organizations have been showing some unwillingness to remove the tender point criteria. Because, tender points have been a definitive feature of fibromyalgia, so eliminating it is causing concerns.
However, this might indicate that we are going in right direction. It is good to argue or have a discussion. There is hope that this will diagnose the syndrome. If you feel like you are having fibromyalgia, a record of all the details of your pain will be kept. You should record all the things like severity, duration, and the circumstances. The doctor will then find it easy to understand the symptoms.
These indexes are taken into account for diagnosis of fibromyalgia. A patient has chances that he is having fibromyalgia if any of these indexes are satisfied and the patient is having symptoms for more than three months
- WPI score greater than 7 and SS score greater than 5
- WPI score between 3 and 6 and SS score greater than 9
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