The Rheumatologist and Fibromyalgia

The Rheumatologist and Fibromyalgia

Have you recently received a diagnosis of fibromyalgia? Finding the right care for your condition is important. The number of symptoms commonly associated with fibromyalgia syndrome makes it difficult to find effective health care. Your primary care physician may suggest you seek treatment from a rheumatologist, a doctor trained in conditions of the joints and muscles, to aid in relief from your chronic pain.

The Rheumatologist

A rheumatologist is a doctor of medicine whose specialty is treating diseases that are rheumatic in nature. These diseases can affect your joints, muscles, or your bones. A rheumatologist can diagnose and treat conditions such as fibromyalgia that result in chronic pain.

Rheumatologists are most commonly referred to as ‘arthritis doctors’. However, they treat a variety of rheumatic illness. A rheumatologist will treat osteoporosis, gout, lupus, autoimmune diseases, osteoarthritis, and fibromyalgia.

The Rheumatologist and Fibromyalgia

While fibromyalgia is not a form of arthritis, it is sometimes thought of as a rheumatic condition. Like arthritis, it causes pain in the joints and muscles. Your primary care provider may feel a rheumatologist can offer you continuing care for your disease because he or she will be familiar with the signs and symptoms of fibromyalgia syndrome. In addition, a rheumatologist will be able to rule out arthritis and other diseases as the cause of your symptoms.

Rheumatologists are experts when it comes to widespread pain. They have specialized equipment and extensive training in diagnostic testing to aid in diagnosing fibromyalgia in patients.

Your Visit with a Rheumatologist

Your first visit to your rheumatologist will include a complete medical history and a review of the current symptoms you are experiencing. The health professional will perform a physical exam while paying close attention to your joints. The rheumatologist will look for swelling and areas of deformity along the joints.

The rheumatologist will also examine:

  • Your range of motion
  • Certain areas for muscle pain
  • Your body for redness and swelling
  • Tender points of the body
  • Your stamina
  • Your force

During your first visit to your rheumatologist, the physician will likely suggest scheduling diagnostic tests. Blood tests, joint aspirations, and imaging tests help in the diagnosis and treatment of fibromyalgia.

Diagnosis and Testing

Tender Points: The American College of Rheumatology is credited with the recognition of fibromyalgia syndrome as a disease with the introduction of its fibromyalgia classification criteria. This classification system aids rheumatologists in the diagnosing of the disease.

There are eighteen tender points located along the body. Theses tender points become sore or painful when pressure is applied. To diagnosis fibromyalgia, a rheumatologist must find tenderness on eleven of the eighteen tender spots and the existence of widespread pain

[1] Widespread pain can exist in the left or right side of the body. Plus, the patient must have had these symptoms for three months or longer.[2]

The exam to identify tender points has been effective for over twenty years. Recently, rheumatologists have been using a more comprehensive exam. This new exam considers more symptoms of fibromyalgia than tender points and widespread pain. It also offers flexibility within the tender point exam itself.

Lab Work: While blood testing will not diagnosis fibromyalgia syndrome, it can help your rheumatologist eliminate it as a cause of your pain. Your rheumatologist may also order lab work to eliminate other medical conditions such as rheumatoid arthritis.

Other lab work includes:

  • Anti-nuclear Antibody Testing – to check for autoimmune diseases including lupus
  • Comprehensive Metabolic Panel – to check electrolytes, proteins, calcium, blood sugar, and the functioning of the liver and kidneys
  • Creatine Kinase – to check for any abnormality that may cause weakness in the muscles or other pain
  • Red Blood Cell Sedimentation Rate – to see if there is a reason for inflammation in the tissues

Joint Aspiration: This procedure is used to remove fluid from around a joint. The rheumatologist will use a needle and syringe to aspirate the fluid from the space surrounding the joint.

The fluid obtained during the joint aspiration procedure will be used to diagnosis and treat joint problems such as gout, some forms of arthritis, infections of the joints, and even fibromyalgia.

Your primary care physician and your rheumatologist will work together to assure you get the best health care services. You will learn self-management techniques to help lessen your pain during your continued care.

References

[1]  Treating Fibromyalgia. (n.d.). Retrieved from American Family Physician: www.aafp.org/afp/2000/1001/p1575.html

[2]  Arthritis/ fibromyalgia. Retrieved from Centers for Disease Control and Prevention: www.cdc.gov/arthritis/basics/fibromyalgia.htm

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015