New Proposed Criteria for Diagnosis More Inclusive

The criteria proposed in 1990 by the American College of Rheumatology for the diagnosis of fibromyalgia included pain present for more than 3 months in all 4 quadrants of the body (above and below the waist on both the right and left sides of the body) combined with 11 out of 18 possible tender points. This set of criteria did not take into account other common symptoms that affect people suffering from fibromyalgia.

The new proposed criteria, published in the May issue of Arthritis Care and Research (a publication of the ACR) add to the previous criteria as follows:

• Include a widespread “pain index” and “severity score”
• Widespread pain index counts the number of areas of the body in which pain has been experienced in the preceding 7 days (there are19 specific areas)
• Symptom severity score- uses a scale from 1 to 3 to assess the extent of 3 common fibromyalgia complaints: fatigue, waking up feeling fatigued or unrefreshed and fibro fog (cognitive dysfunction). An additional score of up to 3 points is awarded for other additional symptoms that may be present, such as dizziness, depression, or gastrointestinal symptoms (i.e. nausea). The patient receives a score between zero (no symptoms) to 12 (severe symptoms).

According to the new proposed criteria, in order for a patient to be diagnosed with fibromyalgia the patient must exhibit:

• Seven or greater areas of pain/tenderness and a symptom severity score of 5 or higher
• Three to six areas of pain/tenderness with a symptom severity score of 9 or greater
• Symptoms must be present for 3 months or more
• The patient cannot have any other illness that might explain their symptoms

The proposed new criteria are more permissive. This means that patients who may have not been diagnosed previously with fibromyalgia may now receive a diagnosis of fibromyalgia should the new criteria be accepted.