Fibromyalgia Diagnosis

1. History of widespread pain of at least three months' duration. Pain must be present in all four quadrants of the body, that is, on both the left and right side of the body and above and below the waist. Axial skeletal pain (cervical spine, anterior chest, thoracic spine, or low back) must also be present.

2. Pain, and not just tenderness on physical examination (digital palpation with an approximate force of four kg), in at least 11 of 18 tender points in muscles, tendons, or bones.

Alternative Diagnosis

Diagnosis of fibromyalgia requires fulfillment of all three major criteria and four or more minor criteria listed below.

Major Criteria

Tender Points of Trigger Points of Pain in Fibromyalgia

1. Generalized aches or stiffness of at least three anatomical sites for at least three months
2. Six or more typical, reproducible tender points
3. Exclusion of other disorders that can cause similar symptoms

For a description of the tender points or trigger points, go here.

Minor Criteria

1. Generalized fatigue
2. Chronic headache
3. Sleep disturbance
4. Neurological and psychological complaints
5. Joint swelling
6. Numbing or tingling sensations
7. Irritable bowel syndrome
8. Variation of symptoms in relation to activity, stress, and weather changes

Fibromyalgia is much more common in females than in males, and most often begins in young adulthood. In most cases, symptoms come on gradually and slowly increase in intensity.

The course of fibromyalgia is unpredictable. Some cases clear up on their own, some become chronic, and some go through cycles of flare-ups alternating with periods of apparent remission.