How can a doctor diagnose Fibromyalgia?

There is a lot of confusion around the diagnosis of Fibromyalgia. I personally have experienced this when I was seeking help for chronic stiffness and pain.

To keep things simple Fibromyalgia or Fibromyalgia Syndrome (FMS) is diagnosed by a doctor, nurse or other medical specialist when you have 11 or more tender points in SPECIFIC places on your body. (This way of diagnosing was current when I wrote this article. It has been superceded by the which you can find here. This does not mean that you will not have the tender points but they are no longer used as the definitive test for Fibromyalgia.)

The following is a diagram of these tender point spots. There are 18 in all and you must have soreness, on touch, in 11 or more to have a diagnosis. (Prior to 2010)



Fibromyalgia is now diagnosed according to criteria published by the American College of Rheumatology: widespread musculoskeletal pain and tenderness measured by the ‘tender point count’ on physical examination.

DIFFICULTY IN GETTING A DIAGNOSIS OF FIBROMYALGIA
There are many reasons why you may find it difficult to get a correct diagnosis.
Here are some I have encountered:

• FMS can exist at the same time as other medical conditions and these can also be pain conditions e.g. I have Polymyositis which is an autoimmune condition which causes weakness and pain in proximal muscles but I also have FMS as I have tender point pain in 11 places.

• There is no specific blood test for FMS.

• There’s no scan, or imaging that can confirm fibromyalgia.

• When blood work and imaging come back “normal,” some doctors may dismiss your symptoms or consider it psychological.

• Many medical specialists believe that fibromyalgia is all in the head and this can range from a variety of opinions from it doesn't exist to, it is due to depression, to it is due to changes in neurochemicals in the brain.

• One specialist told me that FMS is a diagnosis given to people in pain when they have not yet got a complete diagnosis.

• Because symptoms are invisible and vary day-to-day, they can be misunderstood or dismissed.

• FMS causes so many symptoms, not just pain, and the patient may not present with the pain as the other symptoms may be their immediate concern.

• Not all healthcare providers are fully trained or up-to-date on fibromyalgia.

• Some doctors diagnosis or mislabel it as stress, anxiety, or depression because these can all be a part of FMS.

• If you have coexisting conditions (e.g., arthritis or IBS), fibro may be overlooked.

• Symptoms need to be widespread and persistent for at least 3 months.

• A single appointment might not capture the full picture — it often takes multiple visits and tracking symptoms over time.

• Gender Bias

• Fibromyalgia affects more women than men so men may not be as easily diagnosed.

• Some studies show women’s pain is taken less seriously or written off as emotional, which can delay diagnosis.

• Communication Challenges

• Some people don’t realize how much their symptoms matter or may downplay them at appointments.

• Or, they struggle to find the right words to describe symptoms like "fibro fog" or "deep bone pain."

• Seeing the Wrong Specialist

  • Primary care doctors might refer you to rheumatologists, neurologists, endocrinologists, etc.

  • If none see the whole picture, it can lead to a diagnosis maze or even misdiagnosis.

You may also be interested in reading:

• 2010 set of criteria for diagnosing Fibromyalgia.

• What are the main fibromyalgia symptoms?

• How do doctors tell if it's fibromyalgia or another condition?​

Thanks for reading my blog. I am Lee Good and I was diagnosed with Fibromyalgia in 1990 by an endocrinologist. I have spent many years researching and writing about Fibromyalgia.