Medical history (history of illness) represents an important component in the diagnosis of fibromyalgia.
Family history
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Do you have chronic pain in multiple body sites?
- Do you have trouble sleeping or is your sleep not restful?
- Do you suffer from fatigue?
- Do you suffer from a feeling of swelling and/or stiffness of the hands and/or feet and/or face?
- Do you suffer from depressed mood?
- Do you notice concentration problems or short-term memory disorders?
- Are you sensitive to light?
- Do you feel morning stiffness in the trunk, hips and shoulder girdle?
- Do you have paresthesias (sensory disturbances)?
- Do you suffer from irritable bowel symptoms?
- Have you noticed a feeling of swelling in the hands?
- Do you suffer from dizziness or tension headache?
Vegetative anamnesis incl. nutritional anamnesis.
- Do you have menstrual irregularities?
Self history including medication history.
- Pre-existing conditions (infectious diseases)
- Operations
- Allergies
Medication history
- Proton pump inhibitors (proton pump inhibitors, PPI, acid blockers).
- Statins (statin therapy with or without CK elevation).
- Arthralgia (joint pain) and myalgia (muscle pain) associated with aromatase inhibitors and interferons
- For other medications, see “Drug Side Effects” under “Painful Myopathies Caused by Medications.”
To diagnose fibromyalgia, the ACR (American College of Rheumatology) criteria are helpful. They include:
- Extensive pain in the history. Pain is considered extensive when all of the following conditions are met:
- At least 11 of the following 18 points (tender points) are tender to pressure:
- Occiput (Occiput)
- Lower cervical (cervical spine).
- Musculus trapezius (trapezius muscle)
- Musculus supraspinatus (upper bones muscle), a skeletal muscle, this runs almost horizontally above the shoulder
- 2nd rib
- Lateral epicondyle – bone protrusion on the laterally located part of the upper arm bone (humerus).
- Gluteal area (buttocks)
- Trochanter major – bony prominence on the thigh bone.
- Knee
Palpation (palpation) during the physical examination should be performed using moderate pressure. A pressure painful point can be considered positive if the patient perceives the pressure as painful. “Sensitivity” (tender) is not synonymous with “painful.”
The diagnosis of fibromyalgia can be made on the basis of a typical pain history of at least three months’ duration, with at least 11 of the 18 tender points (pressure-painful points) detectable on physical examination.
