Diagnosis
The diagnosis of fibromyalgia and thus the differentiation from other diseases under consideration is extremely difficult (see symptom complex and cause study) and is basically an exclusionary diagnosis, which requires comprehensive examinations in a wide range of specialist areas. Exclusionary diagnosis means that diseases that can be reliably diagnosed are excluded as the cause of the symptoms. X-rays, CT, MRI and blood tests do not provide clear information, but should be performed to exclude organ damage and other causes of chronic generalized pain. Unfortunately, it is still not possible to measure the intensity of pain unequivocally, but the physician can get an idea of the course of the disease pattern by means of a pain diary or pain questionnaire, which also includes questions on vegetative and neuropsychological symptoms. Very often the affected persons have long “patient careers” with partially superfluous diagnostics and correspondingly many therapy attempts behind them.
Diagnostic Criteria
As diagnostic criteria of fibromyalgia are used: Inquiry of the symptom complex and measurable diagnostics
- Chronic musculo-skeletal pain (pain in muscles and skeletal system) for at least 3 months in at least 3 regions
- 11 out of 18 tender points (pain points at the muscle-tendon junction as opposed to trigger points in the muscle belly) must be present; according to the new guidelines, this diagnostic criterion is neglected
- Complaints in the gastrointestinal tract such as nausea, constipation, flatulence, diarrhoea, food intolerances
- The presence of vegetative disorders such as sleep disorders, tiredness and exhaustion, increased sweating, cold hands and feet, dry mucous membranes, dizziness depending on the position of the body, dumpy throat, functional breathing or heart problems
- Neuropsychological symptoms such as anxiety, depression, feelings of being overwhelmed, muscle weakness, balance disorders, sensory deficiencies,
- Complaints from the area of sexuality such as menstrual pain and/or irregularities, sexual indifference
- Measurement of evoked brain potentials results in an increased pain response to a pain stimulus
- Representation of the enlarged pain areas in the brain via PET
- Examination of the skin nerves by punch biopsies
- Investigation of inflammatory processes
