Pain in 11 of 18 tender sites. Classic tender points. Diagnosis also supported by a history of a sleep disorder and daytime fatigue. Must rule out other possible causes of symptoms. Some patients evolve into generalized FMS over time.
Symptoms often begin after injury or trauma.
General demeanor is affected. Helpful to obtain several laboratory tests such as CBC, ESR, TSH and occasionally ANA and RF in order to rule out other diagnostic possibilities. V. Prognosis A. Poor prognostic indicators. Management A. Firm diagnosis ruling out other possible causes of symptoms. 1.Patients are often relieved to learn that their symptoms are not caused by a progressive, crippling or fatal disease.