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Overview: What is Fibromyalgia (FM)?

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How do you know if you have Fibromyalgia?

Prior to the late 1980s, (fibromyalgia) FM was frequently misdiagnosed because no evidence of FM appears on X-rays or through laboratory tests; nor is there a diagnostic marker in the blood. People with FM also often look healthy.

According to Jenny Fransen, R.N., and I. Jon Russell, M.D., Ph.D., authors of The Fibromyalgia Help Book, “One of the most frustrating aspects of fibromyalgia is that others cannot see or feel the magnitude of the pain you are experiencing. Family or friends may remark about how well you look. This is distressingly inconsistent with how terrible you feel.”

A major change occurred when the 1990 American College of Rheumatology (ACR) published criteria for the diagnosis of FM. These criteria were widely accepted because they resulted from research provided by 20 clinical investigators throughout the United States and Canada. In addition, the criteria were simple to learn and use, highly specific and sensitive, and allowed for the identification of individuals with a similar pattern of biochemical abnormalities.

The ACR criteria for the classification of FM are:

History of widespread pain (must be present for at least 3 months)

Pain is considered widespread when all of the following are present:

1. Pain in the left and right side of the body

2. Pain above and below the waist

3. Axial skeletal pain (cervical spine, anterior chest, thoracic spine, or low back)

Pain in 11 of the 18 tender point sites on digital palpation

1. Occiput bilateral, at the suboccipital muscle insertions

2. Low cervical bilateral, at the anterior aspects of the intertransverse spaces at C5-C7

3. Trapezius bilateral, at the midpoint of the upper border

4. Supraspinatus bilateral, at origins, above the scapular spine near the medial border

5. Second rib bilateral, at the second costochondral junctions, just lateral to the junctions on upper surfaces

6. Lateral epicondyle bilateral, 2 cm distal to the epicondyles

7. Gluteal bilateral, in upper outer quadrants of buttocks in anterior fold of muscle

8. Greater trochanter bilateral, posterior to the trochanteric prominence

9. Knees bilateral, at the medial fat pad proximal to the joint line

For a tender point to be considered positive, the subject must state that the palpation was “painful,” a reply of “tender” is not to be considered painful.

Symptoms frequently associated with FM


-Sleep disturbance


-Neurological symptoms


-Irritable bowel syndrome

-Interstitial cystitis (inflammatory disorder affecting the walls of the bladder)

-Numbness and tingling sensations

-Joint pain

-Chest wall pain

-Sensitivity to cold

-Memory and concentration difficulties

-Anxiety and/or depression

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