Fibromyalgia Diagnosis

Currently there is no specific blood test, x-ray or scan that can confirm a diagnosis of Fibromyalgia, and for that reason the condition has become a diagnosis of exclusion. The symptoms patients with Fibromyalgia experience are similar to other conditions, such as Rheumatoid Arthritis, Sjögren’s syndrome or an Underactive Thyroid Gland ^[1]. Therefore, it is not unheard of for a clinician to rule out these conditions before you receive a Fibromyalgia diagnosis. However, it is possible to have these conditions and Fibromyalgia as well ^[2].

In 2010, the American College of Rheumatology, endorsed a new criterion in diagnosing Fibromyalgia. ^{[3, 4]} According to this criterion, you have Fibromyalgia if you meet all three following conditions –

• You have a widespread pain index (WPI) score of seven or higher and a symptom severity scale (SS) score of five or higher. Or you have a WPI score of three to six and a SS score of nine or higher.
• You are experienced symptoms at a similar level for at least 3 months.
• You do not have another disorder that could explain your symptoms.

Despite this, Dr Laurence Knott of Patient Access states “these criteria [sic] are not meant to be used for diagnosis” ^[4] and to date in the UK, the current diagnostic criteria is the ‘tender point’ system, where pressure is applied to 18 tender points and the patient must have at least 11 out of 18 points to receive the diagnosis of Fibromyalgia ^[5]. The patient must also have widespread pain on both sides of the body, upper and lower regions and be present for 3 months or more. 

Regardless of the old system still being in place within the NHS in the UK, the UK Royal College of Physicians, do recognise the new diagnostic criteria ^[6]. They state, “Diagnosing FMS should not become a tick-box exercise” and they “aims [sic] to support correct diagnosis”.

On their website you can also find an ‘Information sheet for clinicians’, and a ‘Fibromyalgia syndrome diagnostic worksheet’ which can be downloaded and contain details on the new diagnostic criteria only.

Beauchemin, M et al., studied in 2019, how long on average it takes for changes in medicine to become widespread practice, and they state that “it takes up to 17 years for only 14% of published evidence to translate into practice.” ^[8] which means it is unlikely that the NHS will start to adopt the diagnostic criteria for Fibromyalgia until roughly 2027, if their study is anything to go off.