Latest criteria for the diagnosis of Fibromyalgia

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) 7 and symptom severity scale (SSS) score 5 OR WPI of 4–6 and SSS score 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, leftRight lower region (Region 4)Hip (buttock, trochanter), rightUpper leg, rightLower leg, right
Right upper region (Region 2)Jaw, rightShoulder girdle, rightUpper arm, rightLower arm, rightAxial region (Region 5)NeckUpper backLower backChestAbdomen
Left lower region (Region 3)Hip (buttock, trochanter), leftUpper leg, leftLower leg, left

Symptom severity scale (SSS) score

  • Fatigue
  • 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.


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