Back To Classification Criteria

Criteria

A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:

1. Widespread pain index (WPI) ≥7 and symptom severity (SS) scale score ≥5 or WPI 3–6 and SS scale score ≥9.
2. Symptoms have been present at a similar level for at least 3 months.
3. The patient does not have a disorder that would otherwise explain the pain.

Ascertainment

1. WPI: note the number 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.
   

   Shoulder girdle, left
   Shoulder girdle, right
   Upper arm, left
   Upper arm, right
   Lower arm, left
   Lower arm, right

   Hip (buttock, trochanter), left
   Hip (buttock, trochanter), right
   Upper leg, left
   Upper leg, right
   Lower leg, left
   Lower leg, right

   Jaw, left
   Jaw, right
   Chest
   Abdomen

   Upper back
   Lower back
   Neck
2. SS scale 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
   

   Considering somatic symptoms in general, indicate whether the patient has:*
   

   0 = no symptoms
   1 = few symptoms
   2 = a moderate number of symptoms
   3 = a great deal of symptoms
   

The SS scale score is the sum of the severity of the 3 symptoms (fatigue, waking unrefreshed, cognitive symptoms) plus the extent (severity) of somatic symptoms in general. The final score is between 0 and 12.

* Somatic symptoms that might be considered: muscle pain, irritable bowel syndrome, fatigue/tiredness, thinking or remembering problem, muscle weakness, headache, pain/cramps in the abdomen, numbness/tingling, dizziness, insomnia, depression, constipation, pain in the upper abdomen, nausea, nervousness, chest pain, blurred vision, fever, diarrhea, dry mouth, itching, wheezing, Raynaud’s phenomenon, hives/welts, ringing in ears, vomiting, heartburn, oral ulcers, loss of/change in taste, seizures, dry eyes, shortness of breath, loss of appetite, rash, sun sensitivity, hearing difficulties, easy bruising, hair loss, frequent urination, painful urination, and bladder spasms.