What is the background to this research?
Fibromyalgia is a condition characterised by chronic pain all over the body, along with fatigue, sleep problems, and difficulty concentrating. Diagnosing fibromyalgia is difficult because there are no blood tests or scans to confirm it. Instead, doctors use check lists of pain locations and severity of symptoms. Studies show that the current criteria (FM2016) don't match well with clinical diagnoses. Some people diagnosed by their doctor do not meet the criteria, while others meeting criteria struggle to get a diagnosis. This mismatch can lead to delays in diagnosis, leaving patients in uncertainty.
What did we seek to find out?
We tested how well the FM2016 criteria identify people with fibromyalgia in the general population. We also explored whether simpler approaches, like asking a single question about widespread pain, could improve identification without losing accuracy.
What did we do?
We analysed pain questionnaire data from over 160,000 participants in the UK Biobank. The survey asked about pain locations, symptom severity, and whether participants had a diagnosis of fibromyalgia from a doctor. We compared the FM2016 criteria against alternatives, including a direct question: "Have you experienced pain all over your body?" We tested different combinations of symptom-scores to find the most effective approach.
What did we find?
The FM2016 criteria were excellent at ruling out those who did not have a diagnosis of fibromyalgia but missed 63% of those with a diagnosis. Asking about "pain all over the body" worked better than complicated counting of body regions. A simplified approach using this question plus easier symptom thresholds identified 46% of those with a diagnosis while still being highly accurate at excluding those without one.
Why does this research matter?
People with fibromyalgia can face years of uncertainty before diagnosis. Our simplified method, starting with one clear question, makes assessment quicker and more patient-centred. While not perfect for individual diagnosis, it could give healthcare professionals and researchers a practical tool to flag potential cases needing further evaluation. This could reduce diagnostic delays and improve care.
Who funded this study?
Jungwoo Kang was supported by the Robert Milne Award (Aberdeen Summer Research Scholarship). The study used UK Biobank data (Application ID 1144). No additional funding was received, and funders played no role in the design or analysis.
Where can I read more?
The full paper can be read here in Seminars in Arthritis and Rheumatism: https://doi.org/10.1016/j.semarthrit.2025.152824