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Fibromyalgia is a chronic condition that causes muscle pain, stiffness, weakness, and general body-wide discomfort. The exact causes are not well understood, so it can be difficult for a doctor to make a definitive diagnosis of fibromyalgia upon an initial visit. Often, confirming the diagnosis involves excluding all other possible causes of symptoms, such as hypothyroidism, sleep disorders, and rheumatoid arthritis. A primary care doctor may consult with several specialists and run a series of laboratory and imaging tests before making a diagnosis of fibromyalgia.
Knowing the risk factors can help a physician consider a diagnosis of fibromyalgia. The condition can occur in people of any age, though it is most commonly seen in women between the ages of 20 and 50. There also appears to be a genetic factor involved, so a complete family history is needed to see if relatives have ever been diagnosed with the condition or another chronic pain disorder. Patients are usually asked to fill out a questionnaire that includes their full medical and family histories as well as their current symptoms before meeting with doctors in person.
Upon examination, a physician typically collects blood and urine samples for laboratory analysis. Complete blood counts and hormone screenings are useful in ruling out other conditions. Many diseases can mimic the symptoms of fibromyalgia but require very different treatment, especially thyroid conditions and certain types of arthritis. If a patient has trouble sleeping, a sleep study may be scheduled with a neurologist to look for signs of insomnia and other chronic sleeping disorders.
In order to confirm a diagnosis of fibromyalgia and determine the severity of symptoms, a doctor may use a digital device called a pressure algometer. The algometer is basically a blunt metal pin attached to a pressure gauge that identifies a patient's pain threshold. The doctor presses the pin against several spots on the body, including the neck, upper arm, chest, lower back, and thigh. When pressure becomes too painful, the algometer is removed and the doctor can compare readings with average pain thresholds. A very low tolerance for pain across all points on the body helps to confirm a diagnosis of fibromyalgia.
Once a confident diagnosis is made, the physician can discuss different treatment options. There are no reliable cures, but a combination of medication, physical therapy, and counseling can help most people find relief from their symptoms. Sleeping pills and muscle relaxers are often prescribed. Patients who exercise regularly, remove caffeine and alcohol from their diets, and try to establish regular sleep schedules often see symptom improvement within a few weeks. Regular sessions with a psychologist can also help people learn to accept their diagnoses and practice stress-reducing lifestyle techniques.
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