Other Tools
Back Pain Questionnaire (for patients)
Back Pain Questionnaire (for providers)
FIBROMYALGIA CRITERIA – 2016
Criteria6
A patient satisfies modified 2016 fibromyalgia criteria if the following three conditions are met:
- Widespread pain index (WPI) >7 and symptom severity scale (SSS) score >5 OR WPI of 4–6 and SSS score >9.
- Generalized pain, defined as pain in at least 4 of 5 regions, must be present. Jaw, chest, and abdominal pain are not included in generalized pain definition.
- Symptoms have been generally present for at least 3 months.
A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses.
Ascertainment
WPI: note the number of areas in which the patient has had pain over the last week. In how many areas has the patient had pain? Score will be between 0 and 19.
| Left upper region (1) | Right upper region (2) | Left lower region (3) | Right lower region (4) | Axial region (5) |
|---|---|---|---|---|
| Jaw | Jaw | Hip | Hip | Neck |
| Shoulder girdle | Shoulder girdle | (buttock, trochanter) | (buttock, trochanter) | Upper back |
| Lower back | ||||
| Upper arm | Upper arm | Upper leg | Upper leg | Chest |
| Lower arm | Lower arm | Lower leg | Lower leg | Abdomen |
Symptom severity scale (SSS) score
For each of the 3 symptoms:
Fatigue | Waking unrefreshed | Cognitive symptoms
Indicate the level of severity over one week using the following scale:
0 = No problem
1 = Slight or mild problems: generally mild or intermittent
2 = Moderate: considerable problems, often present and/or at a moderate level
3 = Severe: Pervasive continuous, life-disturbing problems
The symptom severity scale (SSS) score: is the sum of the severity scores of the 3 symptoms (fatigue, waking unrefreshed, and cognitive symptoms) (0–9) plus the sum (0–3) of the number of the following symptoms the patient has been bothered by that occurred during the previous 6 months:
Headaches = (0 – 1)
Pain or cramps in lower abdomen (0 – 1)
Depression (0 – 1)
The final symptom severity score is between 0 and 12. The fibromyalgia severity (FS) scale is the sum of the WPI and SSS.