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ACR Criteria for the Classification of Fibromyalgia

February 23, 2006

The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia History of widespread pain has been present for at least three months Definition: Pain is considered widespread when all of the following are present: Pain in both sides of the body Pain above and below the waist In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine or low back pain) must be present. Low back pain is considered lower segment pain. Pain in 11 of 18 tender point sites on digital palpation Definition: Pain, on digital palpation, must be present in at least 11 of the following 18 tender point sites: Occiput (2) - at the suboccipital muscle insertions. Low cervical (2) - at the anterior aspects of the intertransverse spaces at C5-C7. Trapezius (2) - at the midpoint of the upper border. Supraspinatus (2) - at origins, above the scapula spine near the medial border. Second rib (2) - upper lateral to the second costochondral junction. Lateral epicondyle (2) - 2 cm distal to the epicondyles. Gluteal (2) - in upper outer quadrants of buttocks in anterior fold of muscle. Greater trochanter (2) - posterior to the trochanteric prominence. Knee (2) - at the medial fat pad proximal to the joint line. Digital palpation should be performed with an approximate force of 4 kg. A tender point has to be painful at palpation, not just "tender." Fibromyalgia Syndrome Symptoms Arthritis and Rheumatism, Vol. 33, No. 2, Feb 1990, F. Wolfe, et al. Condition % of FMS Symptoms Muscular Pain 100 Fatigue 96 Insomnia 86 Joint Pains 72 Headaches 60 Restless Legs 56 Numbness and Tingling 52 Impaired Memory 46 Leg Cramps 42 Impaired Concentration 41 Nervousness 32 Depression (Major Depression) 20 Source of this info: National Fibromyalgia Research Association
PO Box 500, Salem, OR 97308

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