Widespread Pain Index (WPI) was introduced by the American College of Rheumatology in 2010. It measures the number of body regions experiencing pain, out of a Fibromyalgia (FM) is a long-term condition characterised by widespread chronic pain. Other symptoms can include fatigue, trouble thinking or remembering, waking up tired (unrefreshed), pain or cramps in the lower abdomen, depression, or headache. The causes of fibromyalgia are unknown, with several pathophysiologies proposed. Fibromyalgia is estimated to affect 2 to 4% of the population. Women are The 5 body regions are right upper, left upper, right lower, left lower, and axial. The Widespread Pain Index (WPI) was introduced by the American College of Rheumatology in 2010. It measures the number of body regions experiencing pain, out of a total of 19: left and right shoulder girdle, upper arm, lower arm, hip/buttock/trochanter, upper leg, lower leg, and jaw; plus the chest, abdomen, neck, upper back and lower back. The Symptom Severity Scale (SSS) assesses the severity of six symptoms; fatigue (score 0-3, for no problem, mild, moderate and severe), trouble thinking or remembering (0-3), waking up tired (unrefreshed) (0-3), pain or cramps in lower abdomen (0-1), depression (0-1) and headache (0-1). As of 2022, among diagnosis methods in the US, the ACR 2016 criteria have been judged as the best FM diagnosis criteria available. The UK RCP also recommends these criteria for FM diagnosis. A similar diagnostic approach is taken in Germany.In 2019, the American Pain Society in collaboration with the U.S. Food and Drug Administration developed a new diagnostic system using two dimensions. The first dimension included core diagnostic criteria, and the second included common features. The core diagnostic criteria are: A… Fibromyalgia can be viewed as a condition defined by nociplastic pain. Nociplastic pain is caused by altered function of pain-related sensory pathways in the periphery and the central nervous system, resulting in hypersensitivity. As of 2023, the underlying processes of nociplastic pain remain poorly understood. Nociplastic pain may be caused by either (1) increased processing of pain stimuli or (2) decreased suppression of pain stimuli at several levels in the nervous system, or both. Nociplastic pain has been referred to as "Nociplastic pain syndrome" because it is coupled with other symptoms including fatigue, sleep disturbance, cognitive disturbance, hypersensitivity to environmental stimuli, anxiety, and depression. Nociplastic pain states can be triggered by a variety of stressors such as trauma, infections, and chronic stressors. A 2024 review reported that symptoms such as "Generalized pain, defined as pain in at least 4 of 5 regions, is present." "Symptoms have been present at a similar level for at least 3 months." "Widespread pain index (WPI) ≥ 7 and symptom severity scale (SSS) score ≥ 5 OR WPI of 4–6 and SSS score ≥ 9." "A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses." The 5 body regions are right upper, left upper, right lower, left lower, and axial. The Widespread Pain Index (WPI) was introduced by the American College of Rheumatology in 2010. It measures the number of body regions experiencing pain, out of a total of 19: left and right shoulder girdle, upper arm, lower arm, hip/buttock/trochanter, upper leg, lower leg, and jaw; plus the chest, abdomen, neck, upper back and lower back. The Symptom Severity Scale (SSS) assesses the severity of six symptoms; fatigue (score 0-3, for no problem, mild, moderate and severe), trouble thinking or remembering (0-3), waking up tired (unrefreshed) (0-3), pain or cramps in lower abdomen (0-1), depression (0-1) and headache (0-1). As of 2022, among diagnosis methods in the US, the ACR 2016 criteria have been judged as the best FM diagnosis criteria available. The UK RCP also recommends these criteria for FM diagnosis. A similar diagnostic approach is taken in Germany.In 2019, the American Pain Society in collaboration with the U.S. Food and Drug Administration developed a new diagnostic system using two dimensions. The first dimension included core diagnostic criteria, and the second included common features. The core diagnostic criteria are: A history of widespread pain lasting more than three months – affecting all four quadrants of the body, i.e., both sides and above and below the waist. Tender points – there are 18 designated possible tender points (although a person with the disorder may feel pain in other areas as well). The ACR criteria for the classification of patients were originally established as inclusion criteria for research purposes and were not intended for clinical diagnosis, but have later become the de facto diagnostic criteria in the clinical setting. A controversial study was done by a legal team looking to prove their client's disability based primarily on tender points, and their widespread presence in non-litigious communities prompted the lead author of the ACR criteria to question the usefulness of tender points in diagnosis. Use of control points has been used to cast doubt on whether a person has fibromyalgia, and to claim the person is malingering. In 2010, the American College of Rheumatology approved provisional revised diagnostic criteria for fibromyalgia that eliminated the 1990 criteria's reliance on tender point testing. The revised criteria used a widespread pain index (WPI) and symptom severity scale (SSS) in place of tender point testing under the 1990 criteria. The WPI counts up to 19 general body areas in which the person has experienced pain in the preceding week. The SSS rates the severity of the person's fatigue, unrefreshed waking, cognitive symptoms, and general somatic symptoms, each on a scale from 0 to 3, for a composite score ranging from 0 to 12. The revised criteria for diagnosis were: