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People with fibromyalgia may have additional symptoms, such as:

• Trouble sleeping
  
• Morning stiffness
  
• Headaches
  
• Painful menstrual periods
  
• Tingling or numbness in hands and feet
  
• Problems with thinking and memory (sometimes called "fibro fog")

Research shows that people with FMS typically see many doctors before receiving the diagnosis. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, overlap with many other conditions. Therefore, doctors often have to rule out other potential causes of these symptoms before making a diagnosis of fibromyalgia.

 

Another reason is that there are currently no diagnostic laboratory tests for FMS; standard laboratory tests fail to reveal a physiologic reason for pain. Because there is no generally accepted, objective test for fibromyalgia, some doctors unfortunately may conclude a patient's pain is not real, or they may tell the patient there is little they can do.

 

A doctor familiar with fibromyalgia, however, can make a diagnosis based on two criteria established by the ACR (American College of Rheumatology): a history of widespread pain lasting more than 3 months and the presence of tender points. Pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia. The ACR also has designated 18 sites on the body as possible tender points.

 

For a fibromyalgia diagnosis, a person must have 11 or more tender points. (See illustration below.) One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.

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The location of the nine paired tender points that comprise the 1990 American College of Rheumatology criteria for fibromyalgia.