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Related Experiment Video

Updated: Jul 13, 2026

A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers

A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers

Published on: January 5, 2024

Fibromyalgia: a rheumatologic diagnosis?

Gerhard K M Endresen¹

¹Department of Rheumatology, The National Hospital Rikshospitalet, Forskningsvn. 2, Block B, 0027 Oslo, Norway. gerhard.endresen@rikshospitalet.no

Rheumatology International

|July 21, 2007

Summary

Fibromyalgia (FM) is a functional somatic syndrome (FSS), not a rheumatologic condition. Tender points lack validity and should be excluded, focusing instead on chronic widespread pain and central nervous system mechanisms for better patient care.

Area of Science:

Medical Science
Rheumatology
Neurology

Background:

Fibromyalgia (FM) is classified as a functional somatic syndrome (FSS).
Current diagnostic criteria include chronic widespread pain (CWP) and 11/18 tender points (TP).
FM frequently co-occurs with other FSSs, with auxiliary symptoms potentially indicating other conditions.

Purpose of the Study:

To re-evaluate the classification and underlying mechanisms of Fibromyalgia.
To propose a shift in understanding FM from a rheumatologic condition to a broader category of FSSs.
To advocate for the exclusion of tender points from diagnostic criteria due to lack of validity.

Main Methods:

Review of existing classification criteria for FM and other FSSs.
Analysis of the pathological significance of tender points in FM.

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Published on: January 5, 2024

Comparison of central nervous system mechanisms in FM versus peripheral mechanisms in rheumatology.

Main Results:

Tender points lack demonstrable pathology and are indicative of lowered pain thresholds, not specific to FM.
High tender point counts correlate with distress and non-specific somatic symptoms, independent of chronic pain.
Abnormal mechanisms in FM are primarily related to the central nervous system, not peripheral rheumatologic pathways.

Conclusions:

Fibromyalgia should be reclassified as a functional somatic syndrome, not a rheumatologic condition.
Exclusion of tender points from diagnostic criteria is recommended due to their lack of validity.
Integrated, multi-specialty care by general physicians is suggested for patients with FSSs, including FM.