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For the most part, routine laboratory testing reveals nothing.  However, upon physical examination, patients will be sensitive to pressure in certain areas of the body, called tender points (indicated by the flowers placed on the graphics to the left).  To meet the diagnostic criteria, patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and at least 11 of the 18 specified tender points. These 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee and elbow regions.  Roughly 75% of CFS diagnosed patients will meet the FMS criteria.

While many chronic pain syndromes display some symptoms that overlap FMS, the 190 multi-center criteria study (published in the Feb. '90 issue of Arthritis and Rheumatism) evaluated a total of 558 patients, of which 265 were classified as controls.  These control individuals weren't your typical healthy "normals".  They were age and sex matched patients with neck pain syndrome, low back pain, local tendinitis, trauma related pain syndromes, rheumatoid arthritis, lupus, osteoarthritis of the knee of the knee or hand, and other painful disorders.  These patients all had some symptoms that mimic FMS, but the trained examiners were not foiled-they hand-picked the FMS patients out of the "chronically ill" melting pot with an accuracy of 88%.  FMS is not a wastebasket diagnosis!

What if you have widespread pain, but you only have seven or eight of the diagnostic tender points.  A 1996 consensus report by 35 researchers says that you may still be diagnosed with FMS as long as you also battle many of the associated symptoms described on the next page.