How are Fibromyalgia and MS Diagnosed?
Fibromyalgia diagnosis is a little tricky, to say the least. To meet the criteria for a fibromyalgia diagnosis, the person must have: a) widespread pain in all four quadrants of the body for at least 3 months; b) at least 11 of the 18 specified "tender points." This can be challenging, but a skilled professional should be able to determine who meets these criteria with pretty good accuracy. However, this is complicated by the fact that a group of experts issued a consensus in 1996, saying that the "11 tender points" are not necessary for diagnosis, as long as there was widespread pain and many of the symptoms in the list at the beginning of the article.
Diagnosis of multiple sclerosis relies heavily on the presence of lesions on the brain or spinal cord, as seen on an MRI scan. This can also be a little tricky, as these lesions can be hard to spot, especially if they are not "active," and can even be nonexistent in some cases of primary progressive or secondary progressive MS. In these cases, diagnosis really relies on ruling out other possible conditions and evaluating symptom history, as well as the results of neurological exams. It can be a lengthy process to get a definitive MS diagnosis.
There are no blood tests to definitively diagnose either fibromyalgia or multiple sclerosis, much of these diagnoses are really left to the interpretation of the physician, and many of the symptoms of both diseases can come and go. Given these factors, I am fairly certain that there are a pretty large number of people that are misdiagnosed – either people with MS who actually have fibromyalgia, people with fibromyalgia who actually have MS, or people with both that have only been diagnosed with one of the conditions. I am also sure that there are many people with either fibromyalgia or MS who have not been diagnosed with either.
The Bottom Line
Given the overlap in many of the symptoms of these diseases, as well as the similar risk profiles and diagnostic challenges, it seems plausible that there are people who have both MS and fibromyalgia. If you have one or the other, but suspect that there is still something else wrong (for instance, you have fibromyalgia and widespread pain, but also feel significant weakness in your legs or have other MS symptoms) you should not hesitate to pursue answers further. Ask for a referral to a rheumatologist (or a neurologist for MS symptoms) to get additional information and a second opinion.
There is no cure for either disease, but there are medications to treat many of the symptoms, as well as to keep MS from progressing. It is worth your time and effort to keep asking questions and keep seeking improved health and better quality of life.
MedlinePlus. Chronic Fatigue Syndrome.
Weir PT, Harlan GA, Nkoy FL, Jones SS, Hegmann KT, Gren LH, Lyon JL. The incidence of fibromyalgia and its associated comorbidities: a population-based retrospective cohort study based on International Classification of Diseases, 9th Revision codes. J Clin Rheumatol. 2006 Jun;12(3):124-8.