Diagnostic Specialists

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Diagnosing Fibromyalgia will almost always involve a number of different medical specialists. The unfortunate reality of fibromyalgia is that the diagnosis does not usually come quickly, and this can cause considerable frustration for most patients. Since the diagnosis of fibromyalgia is more or less a process of elimination and observation over time, in which similar syndromes and conditions must be ruled out, patients with fibromyalgia may need to visit a number of different specialists along their diagnostic journey in order to definitively determine the root cause of their symptoms.

Because fibromyalgia does not manifest itself in the same way for any two people, the journey of diagnosis is just as individual for each patient as the syndrome itself. Medical specialists are an important part of the process when it comes to diagnosing fibromyalgia. Depending on your symptoms, you may only need to visit one or two specialists before your diagnosis can be made. Those who have a variety of symptoms may find that the process takes longer for them and is more involved. We urge caution and patience, avoiding miss-diagnosis can save valuable time in moving toward effective management!

The following is a non-exhaustive list of certain medical specialists who may need to be involved in the diagnostic process. Examination by these specialists can help to rule out similar and co-morbid conditions and move you closer to a diagnosis of fibromyalgia.

  • General practitioner: General practitioners, also known as family doctors, are typically a patient’s main physician and source of healthcare. They perform annual physical examinations and are trained to treat a number of general and systemic conditions. When you begin to develop symptoms of an illness or disease, you typically consult your general practitioner first. Therefore, you may also refer to your general practitioner your “primary care physician.” Fibromyalgia patients may present to their general practitioner initially. While a general practitioner can establish a diagnosis of fibromyalgia, they may also refer the patient to appropriate specialists in order to rule out (or co-diagnose) other conditions, such as rheumatoid arthritis or chronic fatigue syndrome. A general practitioner can also help a fibromyalgia patient assemble a multidisciplinary team of specialists to help treat their disease once a diagnosis is achieved.
  • Rheumatologist:  Rheumatologists are internal medicine physicians who have received additional training in the diagnosis and treatment of arthritis and other diseases of the muscles, joints, and bones. Rheumatologists commonly treat arthritis, autoimmune diseases, pain disorders, and osteoporosis. Many individuals with fibromyalgia may see a rheumatologist early in the course of their diagnosis in order to rule out arthritis and other musculoskeletal pain disorders. If an individual is experiencing joint pain, stiffness, and swelling, along with chronic fatigue and tiredness, a rheumatologist may be helpful to exclude rheumatoid arthritis as a differential diagnosis. Individuals with other symptoms may have to rule out lupus or other auto-immune diseases first as well.
  • Neurologist:  Neurologists are medical doctors who specialize in the diagnosis and treatment of diseases that affect the nervous system. Like rheumatologists, neurologists are often one of the first specialists seen by fibromyalgia patients on their quest for a diagnosis, as certain neurologic diseases must be excluded. For example, in individual who is experiencing shooting pain in the lower back and down both legs may need to visit a neurologist in order to rule out a ruptured spinal disc or pinched nerve. In addition, the current understanding of fibromyalgia among many experts is that it results from the body’s inability to process painful stimuli correctly. Since nerves are the means by which the body transmits and processes pain, neurologists are often integral members of a fibromyalgia patient’s diagnostic team.
  • Orthopedist:  Orthopedists are medical doctors who specialize in diseases and injuries of the musculoskeletal system, which includes muscles, bones, tendons, and ligaments. While the prevailing understanding of fibromyalgia is that it results from the body’s inability to properly process pain signals, rather than actual bone or joint disease, an orthopedist can be a useful specialist to diagnose fibromyalgia. Much like a rheumatologist, orthopedists can help to rule out other diseases that have similar symptoms, such as osteoarthritis and rheumatoid arthritis. For example, an individual who’s fibromyalgia manifests itself mainly as persistent pain in their knees, hips, and neck may at first need to visit an orthopedist to rule out a diagnosis of osteoarthritis.
  • Psychiatrist:  Psychiatrists are medical doctors who specialize in the prevention, diagnosis, and treatment of mental illness. They also monitor the effects of mental illness on other physical conditions, including heart disease and high blood pressure. Psychiatrists are well-trained to help patients who are suffering from depression and anxiety, both of which are extremely common among fibromyalgia patients. Psychiatrists are important to consult in the diagnostic process if a fibromyalgia patient is experiencing anxiety and/or depression.
  • PsychologistPsychologists are specialists who have received extensive post-graduate education in the assessment, diagnosis, treatment, and prevention of mental disorders. Psychologists can be instrumental in the care regimen of patients who are suffering from depression and anxiety, by helping them recognize events that trigger or worsen their depression, and identifying ways to cope with symptoms. Like psychiatrists, psychologists can be a vitally important part of the diagnostic process for fibromyalgia patients.

 

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Carol Gemberling Stewart January 6, 2013 at 2:25 am

Don’t forget to mention the nurse practitioner as an individual who might be intimately involved with the care of individual patients with Fibromyalgia, Chronic Fatigue Syndrome, Irritable Bowel Syndrome and Interstitial Cystitis, Insomnia, Depression, Anxiety and Chronic Pain to name just a few of the co-morbid conditions. As a Nurse Practitioner who has treated the above, it would be in the best interest of patients to know who these providers are when they select or schedule an appointment with their primary care provider. Thank you and let me know if you should need further information.

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