Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
New Test for Doctors to Diagnose Fibromyalgia in Patients With Pain
Posted in Fibromyalgia by Dr. Sharon Orrange on Jan 08, 2014
The diagnosis of fibromyalgia has been centered around tender areas, trigger points, felt during physical exam. As it turns out, a new study has shown that a two-page questionnaire filled out by a patient is more helpful than a tender-point exam for diagnosing fibromyalgia. It’s not just about the tender points.

What is a tender point exam? Physicians have been trained, and it has been recommended by the American College of Rheumatology, that if pain is elicited by pressing on the 18 tender points this may be consistent with fibro. What we are seeing is that this can make even healthy people flinch in pain.

Instead of pressing on tender points to diagnose fibromyalgia, a two-page questionnaire was just as accurate.

What’s in the questionnaire? Patients check off areas of the body in which they’ve experienced pain in the past week. You quantify on a scale of 0-3 the degree of fatigue, extent of waking from sleep feeling unrefreshed, and cognitive symptoms (fuzzy head, forgetfulness, lack of concentration.) Pain in 7 or more areas of the body and a symptom severity score of at least 5 indicates the presence of fibromyalgia.

Who should be given the questionnaire by their doctor? Patients who have the widespread pain present for longer than 3 months, fatigue, and poor sleep. Those are the folks where fibromyalgia is a thought.

What else should be ruled out? If you have the above listed symptoms, it’s important that your doctor check some other laboratory tests, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), a complete blood count, liver, and kidney tests, thyroid hormone among other things, before concluding you have fibromyalgia.

- Dr. O


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CONDITIONS AND COMMUNITIES: Chronic Pain  •  Fibromyalgia
TAGS: Symptoms  •  Therapies  •  New Technologies

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I have SLE, discoid lupus, nephritis lupus so I have all the above symptoms but could that be from my lupus or side effects of all my meds or can I also have fibromyalgia as well? Even if it is diagnosed as fibro, is there really anything they can do?
By bookkeeper64  Jan 10, 2014
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