The only sure way to find the right health care provider is by trial and error. You can narrow the field by talking to other people, especially people with fibromyalgia or who suffer some kind of chronic pain, and asking for recommendations. Rheumatologists are specialists in treating fibromyalgia, but many times an internist or family doctor is just as knowledgeable and helpful as a specialist.



Make an appointment with your chosen health care provider and tell him or her your story. Describe your pain and other symptoms and tell her how long you have had them. Answer their questions, and get a sense for how you are being treated. If you feel disrespected, or that you are not being taken seriously, make an appointment with a different health care provider. Keep going until you find a professional that you can relate to. Diagnosing and treating fibromyalgia is a partnership between you and your healthcare provider, and you need to be able to work together on this.

You can expect that a health care provider who is knowledgeable about fibromyalgia will take a health history, perform a physical examination, do some blood work and perform a point tenderness test. That's the minimum.

The blood work will usually be to make sure there aren't other problems, like rheumatoid arthritis, causing your symptoms. The real “test” for fibromyalgia is trigger point tenderness. The doctor will press on 18 specific areas of your body to test for tenderness. If you have achiness all over and are unusually tender over 11 or more of these trigger points, they will usually conclude that you have fibromyalgia.

Even this is a bit tenuous, though, because, as you know, the pain of fibromyalgia comes and goes. There are many other trigger points over your body that may be tender. The ones that are used for diagnosis were chosen by researchers as the ones most commonly affected.

Until recently, there have been no diagnostic tests for fibromyalgia, other than trigger point tenderness. A few tests are beginning to be used now, though. Your doctor may or may not order these tests; they are not widely used yet and their usefulness hasn't been proven. The tests are:

* Cytokine levels, which are often abnormal in people with fibromyalgia.

* APA assay (antipolymer antibody). APA levels are thought to be elevated in people with fibromyalgia.

* Sleep study. This may be done both because most FMS patients have sleep abnormalities, so an abnormal sleep test makes the diagnosis clearer, and to identify and treat specific sleep problems.

* MRI or PET scan. People with fibromyalgia have abnormalities in both MRI and PET scan.

* EEG. Some researchers have discovered EEG abnormalities in people with fibromyalgia.

As more research is done, better, more definitive tests for fibromyalgia may become available. That would be a huge benefit for both patients and health care providers, because diagnosing fibromyalgia would be easier and more certain.