Tests for Fibromyalgia?

            Wouldn’t it be nice if you could just tell your chiropractor, primary care doctor, nurse practitioner, or physician assistant about how you’re feeling and have the condition easily diagnosed and treated? With fibromyalgia (FM), it NEVER works that way! Some doctors even think FM is a mental issue and don’t believe it’s a “real” condition. Others over-diagnose everyone with FM and place them on medications that sometimes carry side effects that are worse than the condition. Let’s take a look at the diagnostic criteria for FM and discuss what you might expect in regards to tests....

            The Diagnostic Guidelines for Fibromyalgia currently state three things: 1) Pain that is widespread in all four quadrants of your body. 2) Pain that has been present for at least three months. 3) There are no other diseases causing these symptoms. In other words, a patient's health history can satisfy the first two criteria and a physical examination and BLOOD TESTS help us rule out other diseases that can cause similar symptom-producing conditions. A commonly ordered blood test is a  “CBC” (complete blood count), which tells us if you have an infection (elevated white blood cells – WBCs) or if you are anemic (low red blood cells – RBCs, low hemoglobin, which makes the blood red). Other tests may look for signs of rheumatoid arthritis, gout, a prior strep infection, lupus, inflammation, or Lyme disease. NONE of these tests tell us if you have FM, but they do help us determine if you have some other underlying condition that may be participating in the symptom picture.

            However, there is a NEW blood test that may predict fibromyalgia that was introduced in October of 2013 at the annual meeting of the American College of Rheumatology. EpicGenetics of Santa Monica, CA calls it the “FM/a” test, and it’s being described as “…objective, very accurate, and definitive.” Because of its high cost ($744) and short track record, it’s currently being used primarily in the difficult-to-diagnose cases. The test works by measuring proteins in the body that lessen pain (which were found to be low in FM patients). Researchers ran this test on 100 lupus patients, 98 RA patients, 160 FM patients and 119 healthy patients and found it positive in 93% of KNOWN FM patients and negative 89% of non-FM patients! Because this was presented at a conference and not yet “peer reviewed” (published in a medical journal), these findings are “preliminary” and must be interpreted with caution.

            A simple/FREE “screen” called the “Widespread Pain Index” (“Google” it) contains two main parts: 1) A pain diagram where you can check off the body parts that hurt; 2a) a Symptom Severity Score where you indicate your level of symptom severity over the past week and 2b) where you check off “Other Symptoms” from a list. There is a scoring method that is simple and described on the form that result in two numbers to determine if you meet the “diagnostic criteria.” We recommend starting with this approach. Print off the form, fill it out and score it yourself, bring that into our clinic, and then ask about your specific case. The MOST important part of this process is the third criteria discussed above: ruling out other conditions (we MUST see you!).

            Chiropractic is “A MUST” on the management “TEAM” for FM patients, and we’re happy to keep you INFORMED of your diagnostic and treatment options!