Fibromyalgia Diagnostic Criteria

I have listed under the Resources page links to where you can find the diagnostic criteria for Fibromyalgia and CFS, but I wanted to make sure I had that as a “staple” on this site also. There’s always someone new being diagnosed with Fibromyalgia and we want to be here to help them!

The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia

History of widespread pain has been present for at least three months
Definition: Pain is considered widespread when all of the following are present:

  • Pain in both sides of the body
  • Pain above and below the waist. In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine or low back pain) must be present. Low back pain is considered lower segment pain.

Pain in 11 of 18 tender point sites on digital palpation
Definition: Pain, on digital palpation, must be present in at least 11 of the following 18 tender point sites:

Occiput (2) – at the suboccipital muscle insertions.

Low cervical (2) – at the anterior aspects of the intertransverse spaces at C5-C7.

Trapezius (2) – at the midpoint of the upper border.

Supraspinatus (2) – at origins, above the scapula spine near the medial border.

Second rib (2) – upper lateral to the second costochondral junction.

Lateral epicondyle (2) – 2 cm distal to the epicondyles.

Gluteal (2) – in upper outer quadrants of buttocks in anterior fold of muscle.

Greater trochanter (2) – posterior to the trochanteric prominence.

Knee (2) – at the medial fat pad proximal to the joint line.
Digital palpation should be performed with an approximate force of 4 kg.

A tender point has to be painful at palpation, not just “tender.”

Illustration of Tender Points


Fibromyalgia Syndrome Symptoms

Condition % of FMS Symptoms
Muscular Pain 100
Fatigue 96
Insomnia 86
Joint Pains 72
Headaches 60
Restless Legs 56
Numbness and Tingling 52
Impaired Memory 46
Leg Cramps 42
Impaired Concentration 41
Nervousness 32
Depression (Major Depression) 20

Source: National Fibromyalgia Research Association

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