Diagnosing Fibromyalgia

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Fibromyalgia is a complex, chronic condition that causes widespread pain, fatigue, and cognitive challenges. 

Diagnosis is usually made by a family doctor or rheumatologist, but it’s not always straightforward. 

Historically, the tender point test was used—but studies show it was often applied incorrectly and lacked sensitivity as it was often done incorrectly. *

The tender point test investigated 19 pain locations and 6 self-reported symptoms: difficulty sleeping, fatigue, poor cognition, headaches, depression, and abdominal pain. It would help a GP get insight into your symptoms and their severity.

 What’s Changed?

The updated diagnostic criteria emphasizes a multidimensional approach that better reflects the lived experience of fibromyalgia. Instead of focusing solely on physical exam findings, doctors now use a combination of:

• Widespread Pain Index (WPI): Assesses pain in 19 body regions.

• Symptom Severity Scale (SSS): Rates fatigue, unrefreshing sleep, cognitive symptoms, and other somatic complaints like headaches, depression, and abdominal pain.

• Duration of Symptoms: Symptoms must be present at a similar level for at least three months.

• Exclusion of Other Conditions: Doctors must rule out other causes of pain and fatigue, such as autoimmune diseases or thyroid disorders.

This updated framework helps GPs and specialists gain a clearer picture of symptom severity and distribution—especially when symptoms overlap with other chronic illnesses.

The 2016 revisions to the 2010/2011 criteria for diagnosing Fibromyalgia remain the most widely recognized and validated framework for diagnosing fibromyalgia, especially in clinical and research settings.

Summary of the evolution:

• 1990: Tender point exam introduced—limited and often misapplied

• 2010: Shift to patient-reported symptoms (WPI + SS)

• 2011: Refinements to improve usability

• 2016: Further revisions to enhance diagnostic accuracy and better reflect generalized pain and polysymptomatic distress

This progression reflects a growing recognition of fibromyalgia as a multisystem condition, not just a localized pain disorder. The move toward patient-centered criteria has empowered more accurate diagnoses and validation of lived experience.

What Is the Fibro Criteria Survey?

The Fibro Criteria Survey is a self-report tool based on the WPI and SSS. It’s not a diagnostic test on its own, but it can help your doctor understand your symptoms more thoroughly. It’s especially useful for tracking changes over time or preparing for appointments. Get the pdf here.

A Note on Self-Diagnosis

Fibromyalgia should always be diagnosed by a qualified medical professional. While self-advocacy is essential, patients should not diagnose themselves. If you suspect fibromyalgia, bring your symptoms to a trusted GP or specialist and ask for a thorough evaluation.

*  Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267. 

   Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf