© Sweet Livin, Inc.  2011 Chronic Fatigue and Fibro Living Chronic/Fibro Pain Overview  The difficulty diagnosing fibromyalgia is that there is no clear-cut test to determine fibromyalgia. No evidence of it appears on X-  rays or in laboratory test results. There is no diagnostic marker in the blood. People with fibromyalgia often look healthy and have  no outward signs of pain or fatigue.  Instead, fibromyalgia is diagnosed by the identification of symptoms and the exclusion of other conditions. In 1990, the American  College of Rheumatology, the official body of doctors who treat arthritis and related conditions, developed criteria for the  diagnosis of fibromyalgia. It is diagnosed when the patient displays the following symptoms:  • A history of widespread pain (pain on both sides of the body and above and below the waist) that is present for at least three  months. • Pain in at least 11 of 18 tender-point sites. These points are considered positive when pain is felt upon the application of 4  kilograms of pressure – the approximate amount of pressure required to blanch the examiners’ fingernail.  It is important to note, however, that these criteria were written to help researchers identify patients for clinical trials, not for  diagnosing the disease in individual people. Not all doctors agree with these guidelines. Some believe that the criteria are too rigid  and that you can have fibromyalgia even if you don’t meet the required number of tender points. Others question how reliable and  valid tender points are as a diagnostic tool.  At least half of the individuals who have the clinical diagnosis of fibromyalgia will not fulfill this definition. Your doctor will  listen to you explain all of your symptoms, will order laboratory tests to rule out other conditions with similar symptoms, and will  use his or her experience to decide if you have fibromyalgia.