What is the typical work-up completed to rule out other conditions prior to making a diagnosis of fibromyalgia (other than history and physical exam)?

I agree with Don and will just add a few things. The workup to a large part depends on how long the person has had similar symptoms. In an individual who has had many regional pain conditions and lifelong issues with sleep, fatigue, or other symptoms of FM, there is very little work up needed. However, if someone without that same history develops sub-acute onset of widespread pain, fatigue, etc., that individual needs a much more extensive workup since in some cases, early autoimmune or other d...

I take a somewhat different view than some of my colleagues. Before one can decide on the proper evaluation of a fibromyalgia patient one must decide, “what is fibromyalgia anyway?”. More about that at another time.

Apparently, chronicity is an important component to deciding on whether fibromyalgia is “benign“ or not for my colleagues but I don’t entirely understand why.

I’ve had the opportunity to be the first to diagnose rheumatoid arthritis in patients whose disease had been overlooked for m...

The diagnosis of fibromyalgia is based on the symptoms of widespread pain, present for at least 3 months and associated symptoms, including fatigue and sleep disturbances. A musculoskeletal examination should be adequate to detect inflammatory joint findings, muscle weakness, or neurologic signs. Laboratory studies and X-rays, in general, are not helpful, but most clinicians obtain an ESR (or CRP), CBC, and thyroid function tests. The experience and comfort level of the clinician correlates with...