Fibromyalgia diagnosis cannot be done by a blood test or x-ray. It is done through clinical history and physical examination of the patient and by excluding other medical conditions.

Fibromyalgia diagnosis is based purely on clinical history and physical examination of the patient. There is no blood test or x-ray available that will aid in the diagnosis of fibromyalgia.

It has been identified that patients with widespread body pain will experience pain in at least 11 out of the 18 classic tender points. Usually there is no accompanying tissue swelling or inflammation.

Fibromyalgia can be a diagnosis of exclusion and it is important to rule out other medical conditions, whose symptoms can mimic fibromyalgia. Some of these medical conditions include:

• Parathyroid disease
• Hypothyroidism
• Hypercalcemia
• Polymyositis (muscle disease)
• Paget’s disease (bone disease)
• Infectious diseases such as hepatitis, AIDS
• Infection caused by Epstein Barr virus
• Cancer

Blood tests are carried out to exclude Parathyroid disease, hypothyroidism and hypercalcemia. An enzyme blood alkaline phosphatase is elevated in patients with Paget's disease. Another enzyme CPK is elevated in polymyositis patients. A complete blood count will help to rule out infectious diseases.

Systemic rheumatic conditions can be ruled out by checking out for inflammation and tissue damage.

Once all these conditions are ruled out it becomes easy to diagnose fibromyalgia.