A. Definition
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory problems, and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. It is thought to be the result of overactive nerves. There are guidelines that can be very helpful in the diagnosis of fibromyalgia. In 1990, the American College of Rheumatology published the following criteria to define the disorder:

  • Widespread pain above and below the waist, on the right and left sides of your body, and in the axial skeleton (your skull, spine, rib cage, and the bones in your throat and ears) for at least 3 months; and
  • Tenderness or pain in 11 of the 18 “tender points” on your body.

B. General information
Fibromyalgia is one of the most common chronic pain conditions. It affects more than 5 million people in the United States. That’s nearly 1 in every 60 Americans.

The cause of fibromyalgia is unknown but is believed to involve psychological, genetic, neurobiological, and environmental factors. There is evidence that environmental factors and certain genes increase the risk of developing fibromyalgia; these same genes also are associated with other functional somatic syndromes and major depressive disorder. The brains of fibromyalgia patients show functional and structural differences from those of healthy individuals, but it is unclear whether the brain anomalies cause fibromyalgia symptoms or are the product of an unknown underlying common cause. Some research suggests that these brain anomalies may be the result of childhood stress, or prolonged or severe stress.

Fibromyalgia symptoms are not restricted to pain. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some people also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently associated with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms.

Fibromyalgia can mimic other conditions. Seemingly unrelated symptoms may lead your doctor to suspect other diseases. Doctors often test for other conditions such as rheumatoid arthritis, Lupus, multiple sclerosis, Lyme disease, and mononucleosis before reaching a fibromyalgia diagnosis.

C. SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia as a Disability
Fibromyalgia is not included in the Social Security Administration’s (SSA) List of Impairments used to evaluate disability. However, the SSA recognizes that, in some cases, the condition may prevent you from being able to sustain full time work for a year or longer. As with any claim for disability benefits, before you can be found disabled by the Social Security Administration, sufficient objective evidence must support a finding that your impairment(s) limits your functional abilities to the point that you are unable to perform any substantial gainful activity. A physician’s diagnosis alone is not sufficient.

The Social Security Administration uses the 1990 American College of Rheumatology criteria in its evaluation of disability due to fibromyalgia. This includes:

  1. A history of widespread pain, including pain in all four quadrants of the body (the right and left sides of the body, both above and below the waist) and axial skeletal pain (the cervical spine, anterior chest, thoracic spine, or low back), which has persisted for at least 3 months and is expected to last more than 12 months. The pain may fluctuate in intensity and may not always be present.
  2. At least 11 of 18 positive tender points on physical examination. The positive tender points must be found bilaterally (on the left and right sides of the body) and both above and below the waist.
  3. Evidence that other disorders that could cause the symptoms or signs have been excluded.
    Your representative can help you determine whether your fibromyalgia is severe enough for you to qualify for disability benefits under the Social Security Administration.