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Reston Hospital Center
Pediatric Emergency Room

Diagnosis of Fibromyalgia

Fibromyalgia can be difficult to diagnose. Many of the symptoms are similar to other disorders. A history and physical exam will be done. Your doctor will discuss your pain symptoms and check for tender (trigger) points. Tender points are areas of pain throughout your body. Symptoms of chronic and widespread pain must be present for more than 3 months. The doctor will also discuss how much fatigue, waking unrefreshed, and thinking problems you are having.

Testing for tender (trigger) points—According to criteria established by the American College of Rheumatology (ACR), there are 18 specific tender points around the body that are potentially painful when palpated in people with fibromyalgia. These points are located around the neck, shoulder, chest, hip, knee, and elbow regions. Most healthy people have only a few tender points. A diagnosis of fibromyalgia is usually made if 11 of these 18 points result in pain when touched.

Severity and extent of pain—A diagnosis of fibromyalgia is usually made if 7 or more of 19 locations are involved and severity of sleep problems, problems with thinking clearly, and fatigue symptoms is 5 or more out of 12. The diagnosis can also be made with fewer locations (3-6) if the symptom severity is worse (9 or more).

Blood tests—Blood tests cannot identify fibromyalgia. However, your doctor may order these tests to rule out other illnesses that have similar symptoms, such as systemic lupus erythematosus, Lyme disease, rheumatoid arthritis, and other musculoskeletal disorders.

Revision Information

  • Diagnosis. Fibromyalgia Network website. Available at: Accessed September 14, 2016.

  • Diagnosis. National Fibromyalgia Association website. Available at: Accessed September 14, 2016.

  • Fibromyalgia. American College of Rheumatology website. Available at: Updated May 2015. Accessed September 14, 2016.

  • Fibromyalgia. EBSCO DynaMed Plus website. Available at: Updated February 15, 2016. Accessed September 14, 2016.