Intensity of limb pain and fatigue in fibromyalgia syndrome, depressive disorders and chronic back pain

A symptom-based diagnosis of fibromyalgia syndrome (FMS) without tender point examination is needed for primary care. We tested if a symptom-based diagnosis of FMS can be founded on the intensity of the symptoms musculoskeletal pain and fatigue. FMS patients from 4 different settings (n=464 members of the German Fibromyalgia Association DFV, n=33 from a private practice of rheumatology, n=36 from a tertiary care pain department, n=162 from medical expertise), patients with depressive disorders from 2 different settings (n=24 from a university department of psychiatry, n=311 from an out-patient university psychosomatic department), patients with chronic back pain from an out-patient training center (n=691) and persons from a representative German population sample (n=1977) were compared using the subscales of the Giessen subjective complaints list GBB 24. The greatest mean differences between FMS patients and the other samples were found within the subscales"limb pains" and"fatigue". FMS patients scored higher in the subscales"heart problems" and"dyspepsia", but both subscales did not contribute to a differentiation of the samples. The rates of reclassification of the subsamples based on the subcales"limb pains" and"fatigue" ranged between 80 and 93%. High levels of the intensity of chronic widespread musculoskeletal pain and chronic fatigue may form the basis of a symptom-based diagnosis of FMS.