Fibromyalgia Criteria for Fulfilment and Concomitant Pain-Related Diagnoses in Patients Referred for or Labelled as Having Fibromyalgia: A Cross-Sectional Pilot Study

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Background and objectives: Fibromyalgia (FM) is diagnosed using symptom-based criteria, and clinician-assigned labels frequently diverge from them. FM also coexists with pain-generating musculoskeletal disorders. We determined how many patients referred or labeled as having FM fulfilled the 2019 ACTTION-American Pain Society Pain Taxonomy (AAPT) criteria after specialist assessment and compared concomitant pain-related diagnoses and symptom severity by AAPT status. Methods: Single-center cross-sectional pilot study of consecutive adult outpatients attending a pain unit for suspected or previously diagnosed FM. Clinical records were reviewed to determine fulfilment of the AAPT 2019 criteria, identify documented concomitant pain-related diagnoses, and assess symptom severity (FIQR, Zung SAS/SDS, DN4, NRS). Results: Among 76 patients (96.1% female), 28 fulfilled the AAPT criteria (36.8%; 95% CI, 26.9–48.1%). Of these, 25 (89.3%; 95% CI, 72.8–96.3%) had at least one documented concomitant pain-related diagnosis, versus 54.2% of those not fulfilling the criteria (OR, 7.05; 95% CI, 1.87–26.54; p = 0.002). AAPT MET patients had higher FIQR, SAS, SDS and DN4 scores, whereas NRS did not differ significantly. Conclusion: Approximately one-third of patients with an FM label fulfilled the AAPT criteria, and most of those who did also had a concomitant pain-related diagnosis. Comprehensive assessment for coexisting pain generators remains necessary.

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