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Fibromyalgia
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==Differential diagnosis == Conditions which have symptoms that are similar to fibromyalgia, particularly involving '''chronic widespread pain''' and [[fatigue]] should be ruled out, either by the routine tests recommended to aid fibromyalgia diagnosis, or by symptom pattern and history. Differential diagnoses for fibromyalgia include: *'''Inflammatory rheumatic diseases:''' :[[Rheumatoid arthritis]], [[systemic lupus erythematosus]], [[Sjögren's syndrome]], mixed connective tissue disease, scleroderma, or inflammatory spondyloarthritis, inflammatory polyarthritis, polymyalgia rheumatica, inflammatory myopathy or systemic inflammatory arthropathies *'''Musculoskeletal or spinal conditions:''' :[[Myofascial pain syndrome]], hypermobility syndromes including [[Ehlers-Danlos Syndrome]], [[spinal stenosis]], myelopathies, myositis *'''Endocrine and metabolic disorders:''' :[[Hashimoto's thyroiditis (hypothyroidism)]], [[hyperparathyroidism]], acromegaly, and [[vitamin D]] deficiency *'''Gastrointestinal diseases:''' :[[Celiac disease]] or other forms of [[irritable bowel disease]], [[Non-celiac gluten sensitivity]] *'''Infectious diseases::''' :[[Lyme disease]], hepatitis C, and HIV, although these are not routinely tested for, [[Chronic Lyme disease]] may be secondary to fibromyalgia *'''Cancers''' at the very early stages: :fever, night sweats, and weight loss are common signs *'''Neurological conditions:''' :[[Multiple sclerosis]], [[Parkinson's disease]] and peripheral neuropathies *'''Medication-induced pain conditions:''' :statins, [[opioid]]s ([[opioid-induced hyperalgesia]]), some chemotherapy drugs, aromatase inhibitors, and bisphosphonates can cause diffuse pain <ref name="NBK540974">{{Cite book | last = Bhargava | first = Juhi | last2 = Hurley | first2 = John A. | date = 2021 | title=Fibromyalgia| url = http://www.ncbi.nlm.nih.gov/books/NBK540974/|location=Treasure Island (FL)| publisher = StatPearls Publishing|doi=|pmc=|pmid=31082018|quote=|via=}}</ref><ref name="PMC5741304">{{Cite journal | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741304/ | title = Diagnostic confounders of chronic widespread pain: not always fibromyalgia | date = 2017 | journal=Pain Rep.|volume =2|issue = 3 | page = e598 |doi =10.1097/PR9.0000000000000598|pmid = 29392213|pmc=PMC5741304|first =Winfried | last = Häuser | first2 =Serge | last2 =Perrot | first3 = Claudia | last3 = Sommer | first4 = Yoram | last4 = Shir | first5 = Mary-Ann | last5 = Fitzcharles | pages = |quote= | last6 = | first6 = | author-link = Winfred Häuser | authorlink2 = |access-date=|via=}}</ref> The limited laboratory findings along with history and physical examination can help differentiate fibromyalgia from other differentials.<ref name="PMC5741304" />
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