Do you routinely apply the 2010/2011 ACR symptom-based diagnostic criteria for fibromyalgia in your practice, or do you continue to use the 1990 tender point examination to make the diagnosis?

I don’t use tender point counts in my practice: they were discarded after the 1990 criteria for many reasons, including poor inter-rater reliability and the sort of nebulous nature of what was really being measured. The ACR 2016 criteria reference this very issue, noting that some have described tender point counts as “some unspecified combination of tenderness and distress.” Beyond this, the pursuit of pseudo-objective findings on the exam to verify the presence of widespread pain can feel to m...

Fibromyalgia diagnostic criteria have been a source of controversy and multiple revisions. Much of this confusion relates to failing to distinguish classification criteria, established to provide uniform criteria for clinical studies, from diagnostic criteria, which rely on expert opinion. Rheumatologists diagnose fibromyalgia clinically based on symptoms of at least 3 to 6 months of widespread pain, associated with fatigue and sleep disturbances, severe enough to interfere with daily activities...