Physicians are often slow to diagnose fibromyalgia, and multiple reasons may account for the delay, new data suggest.

The results, from a survey that polled 1,622 physicians in eight countries as well as 800 patients with a confirmed diagnosis of fibromyalgia, also show that the condition has significant economic consequences. In short, fibromyalgia can lead to job absenteeism, job dismissal, and loss of income.

The Fibromyalgia Global Impact Survey was developed by the European Network of Fibromyalgia Associations (ENFA), a coalition of patient advocacy organizations, in partnership with Pfizer, Inc. Survey participants were from the UK, France, Germany, Italy, Spain, the Netherlands, Mexico, and South Korea.

In each country, 100 patients with a confirmed diagnosis of fibromyalgia, approximately 100 primary care physicians, and about 100 specialists were interviewed. Specialists included rheumatologists, neurologists, pain specialists, and psychiatrists.

The investigators found a 1.9 to 2.7 year lag from the time a patient initially presents to a physician with symptoms suggestive of fibromyalgia to the time a diagnosis of fibromyalgia is firmly established. Also, between two and four physicians may be needed to reach an accurate diagnosis.

One factor in the delay in diagnosis is the lack of confidence among physicians in diagnosing fibromylagia. For example, between 16% and 71% of doctors said they were “not very” or “not at all” confident about their ability to identify fibromyalgia symptoms. Roughly the same percentage reported being “not very” or “not at all” confident about differentiating symptoms of fibromyalgia from other disorders.

A lack of physician education was also revealed as a major factor in the delay in diagnosing fibromyalgia.

The data also revealed that patients tend to wait anywhere from five months to two years after symptom onset to see a physician. Patients reported that they had believed that they could manage the symptoms on their own or that the symptoms might go away without treatment.

Finally, the survey indicated that patients experience a mean of six to eleven fibromyalgia symptoms, including chronic widespread pain, sleep disturbance, fatigue, and sensitivity to touch. About 20 percent of them had experienced periods of unemployment related to their condition, and about 50 percent of all patients in most countries said they missed ten or more days during the last 12 months because of their condition.

Written by Jill Stein
Jill Stein is a Paris-based freelance medical writer.