Fibromyalgia is diagnosed when the person has widespread pain for more than 3 months
and another disease cannot explain this pain
In this video, I will explain What do we mean by widespread pain
What are other diseases that could look like fibromyalgia?
Is there a mild form of fibromyalgia? Are there other symptoms or only pain?
Are there signs in the body that could suggest fibromyalgia?
Can fibromyalgia fluctuate? Like some days, I feel better, and for others, I am in much pain?
Is there any blood test or image of the brain that can show if I have fibromyalgia or not?
So, let’s talk about the diagnosis of fibromyalgia today
BEFORE I CONTINUE, let me remind you that this video is not intended to provide medical advice,
it is for educational purposes only. If you have a medical condition that requires treatment,
please talk to your doctor to get a treatment plan for you. And if there is any emergency,
please go to the nearest emergency department or call an ambulance.
First, I want to ensure everyone understands that the pain from fibromyalgia is real. You may have
been told that your pain is in your head, and you heard doctors saying you were inventing or
imagining this pain. I’m sorry if this happened to you. The problem is that we don’t learn about
chronic pain in medical school, and what causes fibromyalgia. The person with fibromyalgia looks
normal, and they have nothing to show that they have fibromyalgia except what they feel.
Many people with fibromyalgia are not believed, even by their relatives and friends. They feel
that they need to convince everyone that they are in real pain, which is very frustrating.
When they have an acute pain episode, they don’t know if that is a flare-up of the
fibromyalgia or if they are having an injury or disease-causing pain. When they seek medical care,
they are told that pain is explained by their “fibromyalgia”. So, it isn't very encouraging.
Our healthcare system is not prepared to help people with fibromyalgia. And that is very sad.
Fibromyalgia is a malfunction of the pain system. I explain that in another video. You
may watch it here. Basically, we have a pain system like an alarm system of a house. When
the alarm system malfunctions, it will go off constantly, and the volume will be very high.
So, having fibromyalgia is like living in a house where the alarm system is going off all the time,
it is very loud, and you call the firetruck, police or paramedics and they come and tell
you your house is not in danger, that you must be imagining these things. Nobody can hear the
noise, only you. Then, you also start getting depressed, anxious, and having sleep problems.
I also have another video in which I answer a question someone posted on the previous video.
“Why do some people have fibromyalgia and others do not?” There are predisposing factors in life,
like adverse childhood experiences. When a child has emotional stressors, some
centres in the brain do not develop properly, so when this person becomes an adult and has a
painful or stressful event, like a car crash, surgery, an acute pain, they cannot stop the
danger signals in their brain, and they keep feeling that pain, for months, years or decades.
Back to our original question. How is fibromyalgia diagnosed?
The person needs to have widespread pain, which means pain on the right
and left sides of the body. Front and back. Above and below the waist and in the trunk.
This pain has to last for at least 3 months, the person may have good days and bad days,
but the pain has to be present every day, or constant pain.
The pain may be described as tiring, heavy, aching, pressure, numbness,
soreness, deep, and tingling. Another common symptom includes
fatigue. It is a kind of fatigue that does not get better with rest.
They also have mood problems like depression, anxiety, and sleep problems.
It is essential to exclude other causes of this pain. So, when we order blood
tests or imaging studies, we think of any other problem that could be causing these symptoms,
like anemia, hypothyroidism, lupus, vitamin B12 deficiency, diabetes, and kidney or liver failure.
Myofascial pain syndrome is sometimes confused with fibromyalgia, and they can co-occur.
Do you like this video so far? So, give a thumbs up here,
and don’t forget to subscribe to this channel. Myofascial pain is regional pain, affecting the
muscles of one part of the body. Any muscle can be affected by myofascial pain, but the pain is
localized to a region and palpation of the muscle is painful and reproduces the patient's symptoms.
Sometimes the pain from myofascial pain radiates to the arms or legs.
A poor posture or overuse of that muscle may cause myofascial pain.
Myofascial pain that is not treated properly can sensitize the pain system, and then,
the person will start having mild symptoms of fibromyalgia. I see many patients who are
showing some signs of fibromyalgia, they have a mild form of fibromyalgia. We need to help them
before they develop more symptoms of fibromyalgia. When we examine the patient with fibromyalgia
we do not find an injury or inflammation that explains the symptoms in the periphery, but we may
find signs of central sensitization which includes pain when we touch the skin. This is called
allodynia. We may also find hyperalgesia, which is a lot of pain when we do a stimuatlion with
a tiny painful stimulus. This means that their pain system is sensitized and malfunctioning.
But not everyone with fibromyalgia will have allodynia or hyperalgesia. In the beginning,
the mild forms, they don’t have these symptoms. However, in the more severe cases they may have a
paradoxical response, in which they do not feel when we touch them with a light stroke in the
skin, this is called hypoesthesia, and they do not feel pain in the skin, we call this hypoalgesia.
These sensory abnormalities are not confined to any nerve distribution or nerve root distribution,
so we can’t explain them by a neuropathic pain. The brain is responsible for these
altered sensations. So, again, we need to look at abnormal neurological connections in the brain.
Because these sensations and pain are generated in the brain, the person may feel good days and
bad days, that is because the brain can modulate and block sensations like pain.
Unfortunately there are no brain images that we can do today to diagnose if a
person has fibromyalgia or not. Maybe in the future this will be possible.
So, in summary, the diagnose of fibromyalgia is based on clinical symptoms, physical examination
and exclusion of other conditions that could mimic the symptoms of fibromyalgia.
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See you next time. Goodbye!