Living with chronic pain that shifts and changes on an almost daily basis can feel overwhelming. One day your shoulders ache, the next your hips throb, and sometimes the fatigue is so overwhelming you can barely get out of bed. If this sounds familiar, you might be starting to identify with the research around fibromyalgia—and more importantly, how to get answers from the medical system.
Getting a fibromyalgia diagnosis isn’t straightforward. Unlike conditions that show up clearly on X-rays or blood tests, fibromyalgia requires a more complex diagnostic process. Many people spend months or even years visiting different doctors before receiving a definitive answer. The journey can feel frustrating, especially when you’re already dealing with daily pain and fatigue.
Understanding what to expect during the diagnostic process can help you advocate for yourself and find care in the short-term, even as the diagnosis is still pending. While the path to full recognition of your symptoms may take time, knowing the steps involved can make the journey less daunting and more manageable.
Understanding fibromyalgia symptoms
Fibromyalgia affects everyone differently, which is part of what makes diagnosis particularly challenging. The condition’s hallmark symptoms include widespread pain, fatigue, and sleep disturbances, but these can vary dramatically from person to person and even day to day.
Musculoskeletal pain or aches
The pain associated with fibromyalgia often feels like a constant dull ache that affects multiple areas of your body. You might experience tender points—specific spots that are particularly sensitive to pressure. These commonly occur around the neck, shoulders, back, hips, arms, and legs. Some people describe the sensation as burning, stabbing, or throbbing pain.
Chronic fatigue
When living with fibromyalgia, people often have reduced energy levels at all times, worsened after periods of poor sleep quality, intense activity, or prolonged inactivity. Fatigue affects both physical capacity and mental health, contributing to experiences of depression and/or anxiety along with other mental health disorders.
Cognitive decline or disorder
Beyond pain, fibromyalgia frequently causes what many call “fibro fog”: difficulty concentrating, memory problems, and mental cloudiness. Because of these symptoms, fibromyalgia patients often struggle with tasks that require quick processing, which can make many types of work difficult or impossible.
Sleep disturbances
Sleep issues are also common, with many people finding that they wake up feeling unrefreshed despite spending adequate time in bed.
The unpredictable nature of these symptoms often complicates the diagnostic process. You might feel relatively good during a doctor’s appointment, making it difficult to convey the severity of your worst days. Keeping a symptom diary can help you track patterns and provide concrete examples to share with your healthcare provider.
Diagnosing fibromyalgia: a process of elimination
Getting a fibromyalgia diagnosis typically begins with your primary care provider. This initial step is crucial because fibromyalgia shares symptoms with many other conditions, including rheumatoid arthritis, lupus, thyroid disorders, and vitamin deficiencies.
Your doctor will likely start with a comprehensive medical history and physical examination. They’ll want to understand when your symptoms began, what makes them better or worse, and how they affect your daily life. Be prepared to discuss your pain levels, sleep patterns, energy levels, and any other symptoms you’ve noticed. This is where a symptom journal can come in handy.
Since there’s no single test to diagnose fibromyalgia, your healthcare provider will need to rule out other potential causes first. This process might include blood tests to check for inflammatory markers, signs of autoimmune conditions, or nutritional deficiencies. They may also order imaging studies like X-rays or MRIs to examine certain joints and soft tissues.
The diagnostic criteria for fibromyalgia have evolved over the years. Previously, doctors relied heavily on identifying tender points through physical examination. Now, the focus has shifted to evaluating widespread pain that has persisted for at least three months, along with other characteristic symptoms like fatigue and cognitive difficulties.
Your primary care provider might refer you to a rheumatologist—a specialist who deals with conditions affecting joints, muscles, and bones. Rheumatologists have extensive experience with fibromyalgia and can provide a more specialized evaluation. However, depending on your location and insurance, getting an appointment with a specialist might take several weeks or months.
Managing expectations about treatment
Even after a diagnosis, there’s no cure for fibromyalgia. Instead, treatment focuses on managing symptoms and improving quality of life. The point of seeking a diagnosis is the possibility of having your health insurance cover the cost of the treatments that will prove effective at managing your symptoms and allowing you to live a normal life with less pain.
This reality can feel discouraging at first, but many people with fibromyalgia find significant relief through a combination of approaches.
Treating fibromyalgia through physical therapy
Getting a diagnosis can feel like a daunting task that takes too long. And because your symptoms won’t wait for an upcoming diagnostic appointment, finding some kind of treatment in the meantime can be life-changing. This is where a physical therapist can be extremely helpful.
Physical therapy can help with fibromyalgia whether or not you have a formal diagnosis. At Excel Sports and Physical Therapy, our skilled chronic pain PTs can help you develop an exercise program tailored to your specific needs and limitations, teach you pain management techniques, and improve your ability to function as normally as possible.
Movement and exercise rooted in therapeutic principles
Exercise is one of the most effective treatments for fibromyalgia symptoms. However, the key is finding the right type and intensity of activity that helps, rather than hurts, your body. What works for someone else might be too much or too little for you. Our physical therapists can help you start slowly and gradually build your strength and endurance without triggering flares.
Physical therapists can also use various techniques to address other symptoms, such as stiffness, headaches, and pelvic floor issues. The personalized approach of physical therapy makes it particularly valuable for managing multiple symptoms, even as they change. Your therapist can adjust your treatment plan based on how you’re feeling on any given day and help you develop strategies for both good days and difficult ones.
Benefits of physical therapy for fibromyalgia
What makes physical therapy so beneficial is that you don’t have to wait for a diagnosis before starting care for the symptoms you’re experiencing. Plus, your physical therapist will adapt every treatment session to the symptoms you currently have, while keeping preventative care front-of-mind.
This rapid treatment option and adaptive care plan makes PT a great option for many with symptoms and no formal diagnosis.
However, it’s worth noting that some insurance plans require a formal diagnosis before covering the cost of any treatment. If this is the case, please reach out to our team to see what we can do to work with you and your primary care provider to ensure you can access the care you need.
Find treatment for fibromyalgia in St. Louis and St. Charles County
Getting a fibromyalgia diagnosis is often much more like a marathon than a sprint, but you don’t have to navigate this journey alone. While you’re working through the diagnostic process with your healthcare provider, exploring treatment options like physical therapy can help you start feeling better sooner.
Start a conversation about what you’re experiencing by calling one of our clinics in the Greater St. Louis area or by requesting your first appointment online today. We’re on your side and will help figure out the best solution for your unique situation.