The American College of Rheumatology (ACR) is proposing a new set of diagnostic criteria for fibromyalgia to replace the “tender point” criteria. The new guidelines, which are published in the current issue of Arthritis Care & Research, include common symptoms such as fatigue, sleep disturbances, and cognitive problems, as well as pain.
To meet the previous diagnostic criteria, which were established in 1990, patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and experience moderate pain and tenderness at a minimum of 11 of the 18 specified tender points.
“These new criteria recognize that fibromyalgia is more than just body pain,” explains study coauthor Robert S. Katz. “This is a big deal for patients who suffer symptoms but have had no diagnosis. A definite diagnosis can lead to more focused and successful treatment and reducing the stress of the unknown.”
“There are numerous shortcomings with the previous criteria, which didn’t take into account the importance of common symptoms including significant fatigue, a lack of mental clarity and forgetfulness, sleep problems and an impaired ability to function doing normal activities,” said Katz.
According to Katz, fibromyalgia pain may fluctuate, which can affect the number of tender points, and the tender point test did not adequately measure symptom severity or the effectiveness of new treatments. “The tender point test also has a gender bias because men may report widespread pain, but they generally aren’t as tender as women.
Arthritis Care & Research – May 2010;62:Epub.