II. Background

  1. Replaces Tender Points in the diagnosis of Fibromyalgia as of 2010
  2. Updated in 2016 by ACR, adding 4 of 5 regions criteria, simplified Part 2 of the Symptom Severity Score
  3. See Fibromyalgia for the AAPT Diagnostic Criteria

III. Criteria: Widespread Pain Index (WPI)

  1. In the past 7 days, where have you had pain or tenderness (one point for each location, out of 19 possible)
    1. Neck
    2. Upper Back
    3. Chest or Breast
    4. Abdomen
    5. Lower Back
    6. Left jaw
    7. Left Shoulder
    8. Left upper arm
    9. Left lower arm
    10. Left hip or buttock
    11. Left upper leg
    12. Left lower leg
    13. Right jaw
    14. Right Shoulder
    15. Right upper arm
    16. Right lower arm
    17. Right hip or buttock
    18. Right upper leg
    19. Right lower leg

IV. Criteria: Symptom Severity Score (out of 12 possible)

  1. Part 1: Rate each of the following three symptoms, for the past 6 months
    1. Rating scale
      1. Points 0: No problem
      2. Points 1: Slight or intermittent
      3. Points 2: Moderate (considerable problems)
      4. Points 3: Severe (pervasive, life altering)
    2. Questions
      1. Fatigue
      2. Trouble thinking or remembering (cognitive symptoms)
      3. Waking up tired or unrefreshed
  2. Part 2: Assign one point for each symptom that has been bothersome over the last 6 months
    1. Headache
    2. Lower Abdominal Pain or cramps
    3. Depressed mood

V. Interpretation: ACR Diagnostic Criteria for Fibromyalgia (all three must be present)

  1. Symptom Duration of 3 months or more
  2. Generalized pain affects at least 4 of 5 body regions
    1. Left Shoulder or arm
    2. Right Shoulder or arm
    3. Neck or back
    4. Left hip or leg
    5. Right hip or leg
  3. Widespread Pain Index and Symptom Severity Score Composite (see criteria above)
    1. Widespread Pain Index >=7 AND Symptom Severity Score >=5 OR
    2. Widespread Pain Index >=4 AND Symptom Severity Score >=9 OR

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Related Studies

Ontology: Fibromyalgia (C0016053)

Definition (MEDLINEPLUS)

Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia may also have other symptoms, such as

  • Trouble sleeping
  • Morning stiffness
  • Headaches
  • Painful menstrual periods
  • Tingling or numbness in hands and feet
  • Problems with thinking and memory (sometimes called "fibro fog")

No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Definition (NCI) Inflammation and fibrous degeneration of a muscle.
Definition (NCI) A chronic disorder of unknown etiology characterized by pain, stiffness, and tenderness in the muscles of neck, shoulders, back, hips, arms, and legs. Other signs and symptoms include headaches, fatigue, sleep disturbances, and painful menstruation.
Definition (NCI_FDA) Inflammation and fibrous degeneration of a muscle.
Definition (MSH) A common nonarticular rheumatic syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation (trigger points). Muscle pain is typically aggravated by inactivity or exposure to cold. This condition is often associated with general symptoms, such as sleep disturbances, fatigue, stiffness, HEADACHES, and occasionally DEPRESSION. There is significant overlap between fibromyalgia and the chronic fatigue syndrome (FATIGUE SYNDROME, CHRONIC). Fibromyalgia may arise as a primary or secondary disease process. It is most frequent in females aged 20 to 50 years. (From Adams et al., Principles of Neurology, 6th ed, p1494-95)
Definition (PSY) A common nonarticular rheumatic condition that is characterized by muscle pain, tenderness, and stiffness.
Definition (CSP) an acute, subacute, or chronic painful state of muscles, subcutaneous tissues, ligaments, tendons, or fasciae caused by a number of agents such as trauma, strain, occupation, exposure, posture, infection, or arthritis.
Concepts Disease or Syndrome (T047)
MSH D005356
ICD10 M79.7 , M79.1
SnomedCT 1304004, 203101004, 203082005, 203111006, 247365004, 13612005, 156727006, 268107007, 203138004, 24693007, 56557000, 203102006
English Fibromyalgias, Fibrositides, Fibrositis, Muscular Rheumatism, Rheumatism, Muscular, Diffuse myofascial pain synd, Fibrositis unspecified, MPDS-Myofac pain dysfunct syn, Myofac pain dysfunct syndrome, Myofascial pain dysfunct syn, Myofascial pain dysfunction syndrome, myofascial pain dysfunction syndrome, MPD syndrome, muscular rheumatism, fibrositis, fibromyalgia (diagnosis), fibromyalgia, fibrositis (diagnosis), Fibromyalgia syndrome, Diffuse Myofascial Pain Syndrome, Myofascial Pain Syndrome, Diffuse, Fibromyalgia Fibromyositis Syndrome, Fibromyalgia-Fibromyositis Syndrome, Fibromyalgia-Fibromyositis Syndromes, Fibromyositis Fibromyalgia Syndrome, Fibromyositis-Fibromyalgia Syndrome, Fibromyositis-Fibromyalgia Syndromes, Syndrome, Fibromyalgia-Fibromyositis, Syndrome, Fibromyositis-Fibromyalgia, Syndromes, Fibromyalgia-Fibromyositis, Syndromes, Fibromyositis-Fibromyalgia, Fibromyalgia [Disease/Finding], fibromyalgia (FM), fibromyalgia syndrome, pain syndrome myofascial, syndrome fibromyalgia, fibromyalgias, fms, mpd syndrome, fibromyalgia (FMS), Fibromyalgia Syndrome, fibromyositis fibromyalgia syndrome, FMS, Fibrositis unspecified (disorder), Fibromyalgia (finding), Fibromyalgia (disorder), Fibromyositis NOS (disorder), Fibrositis NOS, FIBROMYOSITIS, Fibromyositis, Diffuse myofascial pain syndrome, MPDS - Myofacial pain dysfunction syndrome, Myofacial pain dysfunction syndrome, Myofascial pain syndrome, Muscular rheumatism, Fibromyositis (disorder), Fibrositis (disorder), Muscular rheumatism (disorder), fibromyositis, Fibromyositis, NOS, Fibrositis, NOS, Fibromyalgia, NOS, Fibromyalgia -RETIRED-, Fibromyalgia [Ambiguous], Fibromyalgia, Fibromyositis NOS
Dutch fibrositis, fibromyalgiesyndroom, fibromyositis, spier reumatisme, fibromyalgie, Fibromyalgie, Fibrositis, Myofasciaal pijnsyndroom, Spierreuma, Wekedelenreuma
French Syndrome fibromyalgique, Fibrosite, Rhumatisme musculaire, Fibromyalgie, Fibro-myosite, Fibromyosite, Polyenthésopathie, Syndrome de la douleur chronique myofasciale, Syndrome polyalgique diffus
German Fibromyalgiesyndrom, Fibromyositis, Fibromyalgie, Fibrositis, Diffuses myofasziales Schmerzsyndrom, Muskelrheumatismus, Rheumatismus, muskulärer
Italian Fibromiosite, Sindrome fibromialgica, Fibrosite, Reumatismo muscolare, Sindrome dolorosa miofasciale diffusa, Fibromialgia
Portuguese Síndrome de fibromialgia, Reumatismo muscular, Fibromiosite, Síndrome da Dor Miofascial Difusa, Fibromialgia, Fibrosite, Reumatismo Muscular
Spanish Fibromiositis, Reumatismo muscular, Síndrome de fibromialgia, Síndrome de Dolor Miofascial Difuso, fibromiositis, SAI, fibromiositis, SAI (trastorno), fibrositis, no especificada (trastorno), fibromialgia - RETIRADO - (concepto no activo), fibrositis, no especificada, fibromialgia - RETIRADO -, fibromialgia, no especificada (trastorno), fibromialgia, no especificada, fibromialgia, fibromiositis (trastorno), fibromiositis, fibrositis (trastorno), fibrositis, reumatismo muscular (trastorno), reumatismo muscular, síndrome de dolor miofascial, Fibromialgia, Fibrositis, Reumatismo Muscular
Japanese 線維筋炎, 線維筋痛, 線維筋痛症候群, 結合織炎, センイキンツウショウコウグン, センイキンツウ, ケツゴウシキエン, センイキンエン, キンニクリウマチ, 筋肉リウマチ, 線維筋痛症, 筋リウマチ, 結合組織炎, リウマチ-筋肉
Swedish Fibromyalgi
Czech fibromyalgie, Fibrozitida, Fibromyalgie, Svalový revmatismus, Syndrom fibromyalgie, Fibromyozitida, fibrositis, fibromyalgický syndrom, svalový revmatismus, fibrozitida, myofasciální bolestivý dysfunkční syndrom
Finnish Fibromyalgia
Russian FIBROMIALGIIA, FIBROZIT, REVMATIZM MYSHECHNYI, РЕВМАТИЗМ МЫШЕЧНЫЙ, ФИБРОЗИТ, ФИБРОМИАЛГИЯ
Korean 섬유근육통
Croatian FIBROMIALGIJA
Polish Zapalenie tkanki łącznej włóknistej, Fibromialgia, Reumatyzm mięśniowy
Hungarian Fibromyalgia syndroma, Fibromyositis, Fibrositis, Muscularis rheumatismus, Fibromyalgia
Norwegian Fibromyalgi, Kronisk muskelsmerte syndrom, Fibrositt, Myofascielle smerter, Myofibrositt, Fibromyositt