There are no blood tests nor x-rays that can indicate the presence of fibromyalgia although some tests will be taken to exclude other conditions
such as chronic fatigue syndrome, under-active thyroid, myositis, multiple sclerosis, lupus, Sjorgen's syndrome and rheumatoid arthritis.
The American College of Rheumatology published its criteria for the classification of fibromyalgia in 1990 and this
has become accepted on both sides of the Atlantic. The criteria states that fibromyalgia is present if-
- There is a history of widespread pain. Pain is defined as widespread if it is present on the left side of
the body, the right side of the body, above the waist and below the waist.
- There is pain in at least 11 of 18 tender points when a force of 4kg is applied with the fingers.
The tender points are divided into 9 pairs which are located -
- At the back of the neck behind the ear, where the neck muscles attach to the base of the skull
- Halfway between the base of the neck and the tip of the shoulder.
- Where the back muscles attach to the shoulder blade
- On the front of the neck just above the collarbone
- Just to the right and left of the breastbone about 2 inches below the collarbone
- On each forearm just below and to the outside of the elbow crease
- Just above and to the outside of each buttock
- On the outer upper leg just behind the bony part of the hips
- On the inside of each knee.
It is possible to have fewer than 11 painful tender points and still have fibromyalgia. It is also possible to have other conditions
such as rheumatoid arthritis, lupus and polymyositis as well as fibromyalgia.
