Are the ACR 2010 diagnostic criteria for fibromyalgia better than the 1990 criteria?

Fibromyalgia (FM) is difficult to diagnose and manage chronic pain condition whose symptoms have no clearpathophysiological cause, although it is thought that patient hypersensitivity to a range of stimuli may giverise to mechanical hyperalgesia as a result of altered central nociceptive processing. The 1990 American Collegeof Rheumatology (ACR) classification criteria, which have been widely used in clinical practice, require the exis-tence of chronic widespread pain (CWP) forN3 months, and the presence of at least 11 out of 18 specified tenderpoints upon digital palpation,although this latter criterion has long been criticised. The newer 2010 ACR diagnos-tic criteria state that FM can be defined as CWP associated with somatic symptoms, and recommend the use of awidespread pain index and a scale to rate symptom severity. A modified version of the 2010 criteria removed thephysician assessment of the extent of somatic symptoms and replaced it by a summary score of three self-report-ed symptoms, thus making it easier to use while maintaining its sensitivity. This review discusses the advantagesand limitations of all of these criteria.