When diagnosing fibromyalgia, a patient needs to meet three conditions. These are directly from the American College of Rheumatology.
- The widespread pain index (WPI) is greater than or equal to 7, the symptom severity scale (SSS) score is greater than or equal to 5, the WPI equals 3 to 6, and the SSS score is greater than or equal to 9.
- Symptomatology has been present at a similar level for at least 3 months.
- The patient does not demonstrate any other disorder that would otherwise explain the pain.
Two of those are straightforward. You need to have experienced the pain for a few months, and it can't be caused by a different disorder than a doctor could diagnose like lupus or hyperthyroidism. One of those may prompt follow up questions however. What are the widespread pain index and symptom severity scale? Here is an overview from PatientsLikeMe.
Widespread Pain Index (WPI)
The WPI was introduced in 2010. It is a self-reported measure looking at how widespread pain is throughout the body. The checklist has the patient think about 19 specific areas of the body. For each area that feels pain, they receive one point. The areas are:
- Right and left jaw
- Right and left shoulder girdle
- Right and left upper arm
- Right and left lower arm
- Right and left hip/buttock
- Right and left upper leg
- Right and left lower leg
- Upper and lower back
- Neck
- Chest
- Abdomen
So if you feel pain in your right arm, right leg, upper back, chest and abdomen, that would be a score of 5 on the WPI. This is used in combination with the symptoms severity scale to form a diagnosis.
Symptom Severity Scale (SSS)
The SSS is a tool that looks at symptoms and their effects on patients' lives. This scale evaluates four symptoms specific to a fibromyalgia diagnosis, and scores them on a scale of 0 to 3. With four symptoms being evaluated on a scale of 0-3, the maximum score you can get on the SSS is 12. The scale of 0-3 stands for:
- 0: no symptoms
- 1: mild symptoms
- 2: moderate symptoms
- 3: serious symptoms
The score is based on how severe the symptoms were in the past week. Furthermore, the four symptoms that are evaluated are:
- Fatigue
- Waking from sleep feeling unrefreshed
- Cognitive symptoms (trouble concentrating, confusion, disorientation, and impaired comprehension)
- Somatic symptoms (pain, dizziness, nausea, fainting, and bowel disorders)
These two metrics, when used together, help a doctor understand if the condition you have is fibromyalgia. The two combinations are:
- WPI of 7 or more and an SSS or 5 or more
- WPI of 3 to 6 and an SSS or 9 or more
Healthcare and the medical word can be a confusing place! There are a number of terms and tests used that many people never truly understand. We hope that this helps explain one piece of a complicated condition. Want more health news, information, and support? Stop by PatientsLikeMe!