Maybe not, according to a recent study published in the journal Arthritis Care & Research. The study, an analysis of nearly 500 people who visited a university rheumatology clinic, found that physicians often fail to diagnose patients with fibromyalgia — even when those same patients meet the American College of Rheumatology (ACR) diagnostic criteria.
Fibromyalgia remains somewhat of a mysterious condition. Although most experts agree that it causes chronic unexplained pain, unusual fatigue, and memory problems, no one knows exactly what prompts these symptoms (though theories abound). There’s no simple diagnostic test (like a blood test) or clear-cut way to treat fibromyalgia, either: Patients often try combinations of pain relievers, antidepressants, and anti-seizure drugs.
Of course, you can’t attempt to treat a disease if you don’t even know that you have it, which is why proper diagnosis is so important.
Years ago, doctors used to rely almost exclusively on whether a patient had at least 11 “tender points” during a physical exam, but in 2010 ACR released criteria saying that was no longer necessary. The crux of the latest official fibromyalgia checklist: You must have chronic, widespread pain that lasts three months or more (that isn’t explained by another health problem), coupled with unrelenting fatigue and memory and/or mood problems.
Although these “new” criteria have been around for nearly a decade, it seems that clinicians haven’t totally gotten the message. In the recent Arthritis Care & Research study, nearly 500 patients who came to a university rheumatology clinic were given a survey based on the 2010 ACR diagnostic criteria for fibromyalgia, as well as the Multidimensional Health Assessment Questionnaire that is used to assess functioning in people with a wide variety of rheumatologic conditions. The participants were then evaluated by a rheumatologist.
Of the initial group of patients in the study, 121 met the criteria for fibromyalgia according to survey responses. The physicians diagnosed a total of 104 with fibromyalgia… but that included 43 people who did not meet the ACR criteria. Meanwhile, “physicians failed to identify 60 criteria-positive patients,” the authors wrote.
The authors concluded that “problems regarding clinician bias, meaning of a fibromyalgia diagnosis, and the validity of physician diagnosis were substantial.”
What does this mean for patients who wonder if they might have fibromyalgia, as well as those who’ve already been diagnosed and aren’t sure if the diagnosis is accurate? Since there’s no objective diagnostic test for this condition, your best bet may be to make sure your doctor has evaluated you as thoroughly as possible, which should include ruling out other conditions that may have similar symptoms (such as rheumatoid arthritis, axial spondyloarthritis, and lupus). And of course, when in doubt, don’t hesitate to seek a second opinion.
