The Official Definition of/Criteria for FMS7
The most commonly accepted definition (devised by the American College of Rheumatology in 1990) is that the person affected needs to show:
- History of Widespread Pain
Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of the body, pain above the waist and pain below the waist. In addition there should be pain in the spine or the neck or front of the chest, or thoracic spine or low back.
- Pain in 11 of 18 Tender Point Sites on Finger Pressure
There should be pain on pressure (around 4kg of pressure maximum) on not less than 11 of the following sites:
- Either side of the base of the skull where the subocciptal muscles insert.
- Either side of the side of the neck between the 5th and 7th cervical vertebra, technically described as between the ‘anterior aspects of inter-transverse spaces’.
- Either side of the body on the midpoint of the muscle which runs from the neck to the shoulder (upper trapezius)
- Either side of the body on the origin of the supraspinatus muscle which runs along the upper border of the shoulder blade.
- Either side, on the upper surface of the rib, where the second rib meets the breast bone, in the pectoral muscle.
- On the outer aspect of either elbow just below the prominence (epicondyle)
- In the large buttock muscles, either side, on the upper outer aspect in the fold in front of the muscle (gluteus medius)
- Just behind the large prominence of either hip joint in the muscular insertion of piriformis muscle.
- On either knee in the fatty pad just above the inner aspect of the joint.
Children with FMS
Many children are also now being diagnosed with FMS, often starting with flu-like symptoms and then becoming chronic with sleep disturbance a major feature. Some children also display Attention Deficit Disorder (ADD) symptoms, fatigue, school and behaviour problems and commonly a tendency to allergies. Some FMS experts also find that such children frequently have very loose (hypermobile) joints.
How Many People are Affected by FMS?
Muscular pain which goes on and on for months or years is now very common, often causing sufficient disability to prevent people from working or functioning normally, in fact Fibromyalgia Syndrome (FMS) is now the commonest disorder seen by rheumatologists, after osteoarthritis and rheumatoid arthritis.
Dr.Don Goldberg, Chief of Rheumatology at Newton-Wellesley Hospital and Professor of Medicine at Tufts University School of Medicine, estimates that there are between three and six million Americans affected by fibromyalgia, mainly between the ages of 26 and 35 with the vast majority being women (86% females against 14% males according to many surveys).
Based on population size and surveys we can therefore estimate that between 750,000 and a 1.5 million people in Britain also have fibromyalgia.
In total it is estimated, by Professor Bruce Rothschild of Northeast Ohio Universities College of Medicine, that nearly 25% of patients seen at rheumatology clinics are actually suffering from fibromyalgia.8
How Disabling is Fibromyalgia (FMS)?
100 out of 394 patients (that is 25.3%) with FMS (all female) and 12 out of 44 males (27) were shown in a recent survey to be sufficiently badly affected by the condition as to be unable to work; they were effectively disabled.9