The Problem of Diagnostic Uncertainty of a Patient

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The strain of uncertainty on patients[edit]

In the field of chronic pain, including fibromyalgia, it is not unusual to find patients in a great state of uncertainty. They are uncertain about what fibromyalgia is. They are uncertain as why they are in pain and as to what will work to help it.

It follows that anything that can relieve this often very disturbing state of mind could help the patients. If there is at least a partial explanation, then it might be damaging not to provide it. I do not believe that fibromyalgia is a complete mystery. It is a brain disorder involving pain systems and poor sleep. Evidence shows that some treatments are helpful. As of 2020, the CDC web site stated “The cause of fibromyalgia is not known, but it can be effectively treated and managed.”

The strain on the health system[edit]

As of 2020, it was not unusual for fibromyalgia patients to have seen numerous doctors and to have numerous tests before the diagnosis of fibromyalgia is made. This situation is both unfortunate and unnecessary. It can be screen for quickly with a tool known as the FIRST. Then, if the screen is positive, a test such as the ACR-2016 can be administered. It is not particularly difficult. The odd case is borderline or difficult to diagnose as when a patient has several pain disorders and it is not easy to know if they have widespread fibromyalgia pain or if the wide spread is due to multiple causes. In this case, it is fairly easy to clarify the matter with a tender point exam. Thumb to the 18 tender pints is good, using a mechanical algometer is better, and in the option of the author the best way is the full exam recommended in this Wiki which includes noting associated reactions such as withdrawal, facial expression of pain etc.

The idea method would be an objective test such as an EEG test.