Understanding the Fibromyalgia Pain Scale: A Guide for Patients
When you book an in-person or on-line consultation with a Pain Doctor who specialises in Fibromyaligia, they will explain that in the UK, there are mandatory criteria which are used to ascertain each individual patient’s level of pain.
A Quick Guide to Fibromyalgia Pain Scale Scoring Criteria
NUMBER 1: GENERALISED PAIN
This refers to patients experiencing pain in 4 out of 5 body regions. These areas comprise:
• Right upper region
• Left upper region
• Right lower region
• Left lower region
• Axial [1]
Note: jaw pain, chest pain, and abdomen pain, are not included here, as they are incorporated into the Widespread Pain Index.
NUMBER 2: FIBROMYALGIA SCORE 12 OR HIGHER
This is when the Widespread Pain Index (WPI) is a minimum of 4. For example: “Widespread Pain Index (WPI) 7 and Symptom Severity Score (SSS) 5; or WPI 4 & SSS 9 3” [1].
NUMBER 3: HOW LONG SYMPTOMS HAVE BEEN PRESENT
In order to be diagnosed with fibromyalgia, a patient should have experienced symptoms for at least 3 months [1].
What Are the Different Aspects Relating to the Widespread Pain Index?
PUTTING A SPOTLIGHT ON THE FIVE BODY REGIONS
These provide a score ranging from 0-19. The various body regions related to experiencing pain from fibromyalgia, comprise:
• The right upper region, namely: the jaw, shoulder girdle, arm, and lower arm
• The left upper region, namely: the jaw, shoulder girdle, arm, and lower arm
• The axial region, namely: the neck, upper back, lower back, chest, and abdomen
• The right lower region, comprising: the hip, buttock, leg, and lower leg
• The left lower region, comprising: the hip, buttock, leg, and lower leg [1]
THE SYMPTOM SEVERITY SCORE (Symptom Severity Scale plus Symptoms. Score 0-12)
Symptom Severity Scale (0- 9)
Fatigue: Score 0=none, 1=mild, 2=moderate, 3=severe
Waking un-refreshed: Score 0=none, 1=mild, 2=moderate, 3=severe
Cognitive symptoms: Score 0=none, 1=mild, 2=moderate, 3=severe
Symptoms in the Last Six Months (0-3)
Headaches (0-1)
Lower abdominal pain (0-1)
Depression (0-1) [1].
WPI Score : /19
Note: as your Pain Doctor will tell you:
“Fibromyalgia is a valid diagnosis irrespective of other diagnoses” [1]
When you have your first consultation, your Fibromyalgia Pain Specialist will ask you to fill out the user-friendly ‘Fibromyalgia Diagnostic Questionnaire’ in order to determine whether you meet the UK medical criteria for a diagnosis of fibromyalgia.
In a Nutshell
“A patient meets the diagnostic criteria for fibromyalgia if the following 3 conditions are met:
1. A Widespread Pain Index (WPI) score ≥ 7 and a Symptom Severity (SS) score ≥ 5 OR the WPI score is 4–6 and the SS score is ≥ 9
2. 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
3. Symptoms have been generally present for at least 3 months” [2].
References
[1]. Torbay and South Devon NHS Foundation Trust (2020). “Quick Guide to Fibromyalgia Scoring. “
https://www.torbayandsouthdevon.nhs.uk/uploads/quick-guide-to-fibromyalgia-scoring.pdf
[2]. South East London NHS (2023). “South East London Rheumatology Guidance for the Diagnosis and Management of Patients with Fibromyalgia.”
selondonccg.nhs.uk
