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Fibromyalgia Syndrome (FMS)

 

A diagnosis of fibromyalgia can be made in primary care and there are no additional management strategies available in Rheumatology that are not accessible in primary care.

As there is no secondary care commissioned service for patients with fibromyalgia in Cornwall -

Referrals for fibromyalgia will be rejected. 

 

Diagnosis

A diagnosis of fibromyalgia should be considered in patients presenting with widespread musculoskeletal pain without clinical signs of inflammatory arthritis. 

  1. Symptoms have been present for at least 3 months.
  2. Widespread pain index (WPI) 7 or more, symptom severity (SS) scale  score 5 or more or WPI 3 or more and SS scale score 9 or more.
  3. Generalised pain in 4 or 5 body regions (right upper limb, left upper limb, right lower limb, left lower limb, spine).
  4. Have no alternative explanation.

 

Widespread pain index (WPI):

WPI notes the number of areas in which the patient has had pain in the last week, see below diagram

Symptom Severity Score

Trigger points are not required to make a diagnosis of fibromyalgia but can help confirm your diagnosis (press with just enough pressure to blanch your fingertip – a hyperalgesic response is a positive test).