New criteria proposed for diagnosing fibromyalgia
“The tender point test also has a gender bias because men may report widespread pain, but they generally aren’t as tender as women. Fibromyalgia may be under-diagnosed in both men and women because of the reliance on 11 tender points, and also due to failing to account for the other central features of the illness,” said Katz.
Additionally, due to the confusion regarding the tender point test, the authors note that most primary care doctors don’t bother to check tender points or they aren’t checking them correctly. Consequently, fibromyalgia diagnosis in practice has often been a symptom-based diagnosis. The new criteria will standardize a symptom-based diagnosis so that all doctors are using the same process.
The tender point test is being replaced with a widespread pain index and a symptom severity scale. The widespread pain index score is determined by counting the number of areas on the body where the patient has felt pain in the last week. The checklist includes 19 specified areas.
The symptom severity score is determined by rating on a scale of zero to three, three being the most pervasive, the severity of three common symptoms: fatigue, waking unrefreshed and cognitive symptoms. An additional three points can be added to account for the extent of additional symptoms such as numbness, dizziness, nausea, irritable bowel syndrome, or depression. The final score is between 0 and 12.
This is indeed good news. The tender point test did seem rather minimal since it only takes into account pain and ignores the other predominant symptoms. Certainly, it could lead to earlier diagnosis in FMS patients, because, seriously, if it takes a decade to diagnose someone there are some issues with the methods. I recall when I finally got my diagnosis that they were too late… by then FMS had impaired a great deal of my ability to function in many aspects that I simply had to cope with on my own, often including stopping activities that became too draining or painful, when in fact early treatment would encourage a certain level of activity.
Helping with the cognitive impairments and sleep issues early on sure would have been nice as well. What I most remember of my official diagnosis, which by then was rather moot, was that the tender point test was damn painful. Damn painful and lasted quite a bit after as well. It is like poking a bruise… yeah it hurts and hurts quite a bit if you put that much pressure on it. Of course, there was also some relief. That final moment where finally there is a name for what is wrong with you. And that hope that finally someone will help. Of course, they didn’t then. But the more medications and treatments they look into the better the future outlook for those of us that have this dang syndrome.
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