What are the latest criteria for the diagnosis of Fibromyalgia?
The latest criteria are 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria.
- • Generalized pain, defined as pain in at least 4 of 5 regions, is present.
- • Symptoms have been present at a similar level for at least 3 months.
- • Widespread pain index (WPI) 3 7 and symptom severity scale (SSS) score 3 5 OR WPI of 4–6 and SSS score 3 9.
- • A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses.
Note that the tender point examinations were removed in the 2010/2011 criteria. They were part of the 1990 criteria.
WPI definition: note the number of areas in which the patient has had pain over the last week. In how many areas has the patient had pain? Score will be between 0 and 19.
|Left upper region (Region 1)Jaw, leftShoulder girdle, leftUpper arm, leftLower arm, left||Right lower region (Region 4)Hip (buttock, trochanter), rightUpper leg, rightLower leg, right|
|Right upper region (Region 2)Jaw, rightShoulder girdle, rightUpper arm, rightLower arm, right||Axial region (Region 5)NeckUpper backLower backChestAbdomen|
|Left lower region (Region 3)Hip (buttock, trochanter), leftUpper leg, leftLower leg, left|
Symptom severity scale (SSS) score
- Waking unrefreshed
- Cognitive symptoms
For the each of the 3 symptoms above, indicate the level of severity over the past week using the following scale:
- 0 = No problem
- 1 = Slight or mild problems, generally mild or intermittent
- 2 = Moderate, considerable problems, often present and/or at a moderate level
- 3 = Severe: pervasive, continuous, life-disturbing problems
The symptom severity scale (SSS) score: is the sum of the severity scores of the 3 symptoms (fatigue, waking unrefreshed, and cognitive symptoms) (0-9) plus the sum (0-3) of the number of the following symptoms the patient has been bothered by that occurred during the previous 6 months:
- (1) Headaches (0-1)
- (2) Pain or cramps in lower abdomen (0-1)
- (3) And depression (0-1)
The final symptom severity score is between 0 and 12.
The fibromyalgia severity (FS) scale is the sum of the WPI and SSS.