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The term myalgia suggests the disorder derives at least in part from muscle.

1 Therefore, patient-reported metrics are central to the diagnosis. Criteria are also satisfied if only 3–6 regions are affected by pain but symptoms are more severe (severity score ≥9). In 2010, these criteria were revised to remove the need for tender points on exam, leaving specific, clinical features that were deemed vital to the diagnosis: (i) widespread pain (widespread pain index of ≥7 regions) (ii) at least moderate severity (symptom severity score ≥5) of pain, fatigue, sleep disruption, and cognitive symptoms (iii) duration of symptoms ≥3 months and (iv) absence of a disorder that would otherwise explain the disorder.

small fiber, early or mild sensory polyneuropathyįibromyalgia syndrome (FMS) is a well-recognized and common disorder of chronic widespread pain characterized by specific criteria set out by the American College of Rheumatology (ACR).quantitative sudomotor axon reflex testing.fibromyalgia and small fiber, early or mild sensory neuropathy.Discussion: The FM-SFSPN subset of patients may be identified through sural and MP sensory NCS and/or skin biopsy but cannot be identified by pain features and intensity. Pain intensity and quality did not distinguish patients. Results: Sural and medial plantar (MP) response amplitudes correlated with ENFD, with markers of metabolic syndrome being more prevalent in this subset of patients. Methods: 155 FMS patients with neuropathic symptoms completed a Short Form McGill Questionnaire and visual analog scale in addition to having skin biopsies, nerve conduction studies (NCS), and serologic testing. We aimed to better characterize and distinguish the subset of patients with both fibromyalgia and small fiber, early or mild sensory polyneuropathy (FM-SFSPN). Growing evidence appears to suggest a role for small fiber polyneuropathy (SFPN) in some FMS patients, as measured by epidermal nerve fiber density (ENFD). Introduction: Pain mechanisms in fibromyalgia syndrome (FMS) are not clearly understood.