Table 5.

A new diagnostic criteria for fibromyalgia by the American College of Rheumatology (ACR) in 2016 [17]

Three of four conditions
1. Widespread pain index (WPI) ≥ 7 and symptom severity scale score (SSSS) ≥ 5 or WPI 4–6 and SSSS ≥ 9 in last week
WPI (0–19)			SSSS (0–12)
Region 1 (Left upper region)			Fatigue (0–3)
Left jaw			Wakening unrefreshed (0–3)
Left shoulder girdle			Cognitive symptoms (0–3)
Left arm			Other symptoms (0–3):
Left forearm			Headache (0–1)
Region 2 (Right upper region)			Abdominal pain (0–1)
Right jaw			Depression (0–1)
Right shoulder girdle
Right arm
Right forearm
Region 3 (Left lower region)
Left hip (Buttock and trochanter)
Left thigh
Left leg
Region 4 (Right lower region)
Right hip (Buttock and trochanter)
Right thigh
Right leg
Region 5 (Axial region):
Upper back
Lower back
Chest
Abdomen
Diagnosis of fibromyalgia: WPI ≥ 7 and SSSS ≥ 5 or WPI 4–6 and SSSS ≥ 9
2. Presence of generalized pain, defined as pain at least 4 of 5 regions, excluding the jaw, chest, and abdominal pain
3. Chronic pain over at least 3 mo
4. Independent diagnosis even in the presence of other clinically illness