Some additional tools must be used for fibromyalgia diagnosis. They often give clues that common history description does not. This is particularly true of the first one which is a drawing of the pain.
Drawing of the pain is worth a thousand words and very often has allowed me to suspect fibromyalgia on a patient sent to me for say chronic knee pain.
Look at this drawing: it is a typical fibromyagia picture!
However, it may happen that those drawings evoke a lot of symbolism. To let this happen may distract from the fibromyalgia. Some have even made psychological statements out of them when none was justified.
The second one is the Short McGill Pain Questionnaire, which brings some details on pain description and level.
It shows how much the disease has invaded one’s life and gives clues towards the need and difficulties of teaching coping skills. Coping with fibromyalgia is part of every treatment
The third one is an Anxiety and Depression Scale. It shows how much anxiety the fibromyalgia sufferer is going through as well as depression if any.
This scale, as well as the other tools, is important in the appreciation of any chronic pain. It is chronic pain dependent and has no value in the fibromyalgia diagnosis per se. I am unable to make a diagnosis of fibromyalgia out of it. Like all chronic pains, anxiety and depression are secondary to the disease and are not the cause of it.
Many have attempted to draw parallels between depression and fibromyalgia. The only parallel that exists is the magnesium deficiency! Depression is on the increase as well as magnesium deficiency as is fibromyalgia.
But depression does not mean fibromyalgia and fibromyalgia does not mean more depression. Yes, there is more depression in fibromyalgia sufferers than in the disease-free population but this is also true of any chronic pain!
Finally, and perhaps the most important, is a Disability Scale. Not only does it give an important measure about the function but it is also a major measure of improvement after treatment.
Fibromyalgia, like any other chronic pain disease, can improve with treatment. However, as improvement occurs, the patient’s functions improve and its disability decreases. However, the fibromyalgia sufferer will increase his/her activity up to the same pain level as before! This means that pain as a measure will be the same but disability will be lower. The improvement will appear on the disability scale but not on the pain scale!
It is also an important tool for medico-legal purpose when fibromyalgia has been triggered by a trauma such as a road
traffic accident or an injury at work (IOD or injury on duty) and compensation is sought. Legal cases with fibromyalgia are becoming more frequent and require a good knowledge not only of fibromyalgia but also of the legal rights of fibromyalgia sufferers.
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