When is erythrocyte sedimentation rate (ESR) testing indicated in the workup of fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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The erythrocyte sedimentation rate (ESR) is often recommended as a routine laboratory test in fibromyalgia patients to rule out the presence of inflammatory disorders that may mimic symptoms. The upper limit of normal for the ESR in women is half their age (eg, a level of 40 in an 80-year-old women is normal), and in men is half their age minus 10.

While the ESR is usually normal in patients with fibromyalgia, it is a nonspecific measure of inflammation and mild elevations may not be meaningful. For example, the ESR can be mildly elevated in obese patients. However, a high ESR may be indicative of an inflammatory disorder or occult malignancy that should be thoroughly evaluated.

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