Why Fibromyalgia Is So Hard to Diagnose

Research from the National Fibromyalgia Association shows that it takes an average of three to five years for the condition to be diagnosed.

Many factors contribute to that delay. Fibromyalgia patients can look the picture of health, despite their significant pain, and there's no specific known cause. For doctors, that translates into the frustrating reality that there's no objective diagnostic lab tests they can do. A fibromyalgia diagnosis is based on the patient's description of symptoms.

Andrea Cooper, 52, of Phoenix, Md., is a veteran of doctors' visits. "There have been times when I almost wished a test would come back positive for a 'real' disease so that at least the doctor would know that something was truly wrong," says Cooper. "Coming from a cancer survivor, that's pretty serious stuff."

Diagnosis by elimination
Good medical practice requires that doctors eliminate other possible causes of pain, sleep disorders, and other symptoms before identifying fibromyalgia as the problem.

"I think it's misdiagnosed most of the time when symptoms first present," says Todd Sitzman, MD, a past president of the American Academy of Pain Medicine. "Because by definition it's a diagnosis of exclusion. The physician looks for other sources for their chronic fatigue, for their chronic muscle pain, sleep disturbance, and mood disorder before they assign a diagnosis of fibromyalgia."

Depression is a common misdiagnosis because of overlapping symptoms such as poor sleep, depressed mood, and diffuse body pain.