Fibro Facts Series- Fact #7: For Fibromyalgia diagnosis, Symptom Severity Score (SS) must be at least 5 or 9, depending on WPI

Posted by on Oct 11, 2013 in Fibro Facts, Fibro Pics | 6 comments

Fibro Facts Series- Fact #7: For Fibromyalgia diagnosis, Symptom Severity Score (SS) must be at least 5 or 9, depending on WPI

Fibro Facts, our newest series on Inspired Living with Fibromyalgia, is a series of illustrated facts about Fibromyalgia. The goal is to help increase awareness and understanding for the millions of people living with Fibromyalgia throughout the world and to help people recently diagnosed learn a bit more about Fibromyalgia!


Fibro Fact #7: For Fibromyalgia diagnosis, Symptom Severity Score (SS) must be at least 5 or  9, depending on WPI

When the American College of Rheumatology updated the Fibromyalgia diagnosis criteria in 2010, two new components were added. The Widespread Pain Index (WPI), which we posted about a few days ago and you can click on to learn more, and the Symptom Severity Score (SS), which is the focus of this post.


The Symptom Severity Score takes into account the level of difficulty caused by the three main symptoms  (excluding pain which is measured in the WPI) of Fibromyalgia, which are Fatigue, Waking Unrefreshed, and Cognitive Symptoms and then looks at how many other symptoms are present


For the three symptoms of Fatigue, Waking Unrefreshed, and Cognitive Symptoms, an individual is asked to rank the severity of each symptom individually as level 0, 1, 2 , or 3.


Here is a quick look at the ranking criteria:

0 = Not a problem at all

1 = Slight or Mild Problems, generally mild or intermittent

2 = Moderate; considerable problems, often present and/or at a moderate level

3 = Severe; pervasive, continuous, life disturbing problems

Each of the three symptoms of Fatigue, Waking Unrefreshed, and Cognitive Symptoms will achieve points based on the scale above. So you can have a score of anywhere between 0 (no issues with these three symptoms) and 9 (severe issues with all three symptoms) or somewhere in between. The vast majority of Fibromyalgia patients range somewhere in between the 0 and 9. For instance, if you have moderate fatigue =2, moderate Waking Unrefreshed  = 2, and severe Cognitive Issues = 3, then your SS Score would be 7.


The second part of the Symptom Severity Score takes into account how many of specific symptoms you have experienced over the last week.  Below is a list of the symptoms considered in part 2 of the Symptom Severity Score:


Muscle pain

Irritable bowel syndrome


Thinking or remembering problem

Muscle Weakness


Pain/cramps in abdomen






Pain in upper abdomen



Chest pain

Blurred vision



Dry mouth





Ringing in ears



Oral ulcers

Loss/change in taste


Dry eyes

Shortness of breath

Loss of appetite


Sun sensitivity

Hearing difficulties

Easy bruising

Hair loss

Frequent urination

Painful urination

Bladder spasms

The score for these symptoms is determined by the number of the symptoms you had. The maximum amount of points for these symptoms is 3 total. Basically, the scoring for this section goes as follows:

0 = No symptoms

1 = Few symptoms (1-10)

2 = A moderate number (11-24)

3 = A great deal of symptoms (25 or more)

So the total points possible utilizing both sections of the Symptom Severity Score is 12. In order to have Fibromyalgia, your  SS score must be at least 5 with a WPI score of at least 7 OR the SS score must be at least 9 with a WPI of 3-6.


If you are interested in learning more about the WPI Index  and SS Score, then I suggest looking at the following PDF entitled New Fibro Criteria Survey 2010.  This survey was created by the Fibromyalgia Network and is intended to help with diagnosis of Fibromyalgia. It is very important to understand that people can NOT diagnose themselves with Fibromyalgia, you need a physician, rheumatologist, or neurologist who understands the criteria to actually make the diagnosis and it takes time.

Hello Fibro Friends. My name is Emily. I have Fibromyalgia, but it doesn’t have me, at least not anymore! After coping with the chronic pain and other difficult symptoms of Fibromyalgia for more than a decade, I have learned wonderful ways to improve my quality of life and find inspiration in the world around me. My purpose in life is to increase Fibromyalgia awareness and understanding, while helping others reach an Inspired Life! I love teaching others how to not only cope with Fibromyalgia, but to actually excel at living an abundant, healthy, and inspired lifestyle.

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  1. My mother has this. I wasn’t aware there were so many symptoms that were associated with it. She certainly has had her share of cognitive issues with it as well.

    Thank you for sharing and spreading the awareness.

    Missy Bell

    • Yes, there are actually many more symptoms associated with Fibromyalgia than the ones used in the criteria for diagnosis. The experts focused on the main ones that were seen with the vast majority of people with Fibromyalgia. Best wishes and positive thoughts for your mother. I’m glad you stopped by, the more people understand about Fibro, the more understanding they can be to the people in their lives who have Fibro!

  2. The sad part is it can take a long time to diagnose. The more you educate the public they can at least make the suggestion to the doctor when some of these symptoms are identified and tests don’t reveal something specific.

    • Yes, Linda, that is so true! The average time frame for diagnosis is 5 years. I know people who were not diagnosed with Fibromyalgia after 30 years of seeing doctors and specialists. It is my greatest hope that through education, we help decrease the time frame of diagnosis, so the focus can shift to treatment options.

  3. Unbelievable. I had no idea this new scale even existed!! And I’m a nurse. Good to know. People don’t realize the myriad of symptoms that are related to fibro. I was diagnosed 10 years ago after a car accident with resultant C-spine surgery and fortunately, my diagnosis only took 14 mos. Will definitely pass this on to my P.A. to see if he knows about this. Thanks for the info!!

    • You are welcome. I’m glad you found the information useful!

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