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== Pain in fibromyalgia == Researchers believe that [[fibromyalgia]] (FM) amplifies painful sensations by affecting the way your [[brain]] processes pain signals.<ref name=":0">{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780| title = Fibromyalgia - Symptoms and causes|website=Mayo Clinic|language=en|access-date=2019-05-03}}</ref> Pain in fibromyalgia is commonly referred to as '''chronic widespread pain''' (CWP) that is otherwise '''unexplained''', meaning not caused by another medical condition. Fibromyalgia pain is assessed by a combination of location and frequency: pain must be present at least weekly in each pain location that is counted. Besides pain, additional fibromyalgia symptoms are also required.<ref name="ACR2010" /> ===Widespread Pain Index === Before 2010, a tender point examination was needed to that assessed pain on pressure, but this has now been replaced by the more accurate Widespread Pain Index (WPI). The WPI scores pain in 19 locations: * Shoulder girdle - left and right * Hip (buttock, trochanter) - left and right * Jaw - left and right * Upper arm - left and right * Upper leg - left and right * Lower arm - left and right * Lower leg - left and right * Upper back * Lower back * Chest * Neck * Abdomen Pain in fibromyalgia must not be explained by another medical condition, and must persist for at least three months, and exist in addition to a combination of other symptoms.<ref name="ACR2010">{{Cite journal|url=https://www.rheumatology.org/Portals/0/Files/2010_Preliminary_Diagnostic_Criteria.pdf| title = American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia | last = Wolfe | first = Frederick | date = May 2010|volume =62 | issue = 5 | pages = 600–610| doi = 10.1002/acr.20140|type=PDF|archive-url=|archive-date=|access-date= | authorlink = | last2 = Clauw | first2 = Daniel | authorlink2 = |journal=Arthritis Care & Research | last3 = Fitzcharles | first3 = Mary-Ann | first4 = Don | last5 = Katz | last4 = Goldenberg | first5 = Robert | last6 = Mease | first6 = Philip | last7 = Russel | first7 = Anthony | last8 = Russel | first8 = I. Jon | first9 = John | last9 = Winfield | first10 = Muhammad | last10 = Yunus | authorlink10 = Muhammad Yunus}}</ref> {{See also|Fibromyalgia|Fibromyalgia symptoms||||}} ===Pain types=== Types of pain commonly reported in fibromyalgia include: [[irritable bowel syndrome]], [[paresis|muscle weakness]], [[headache]], [[paresthesia|numbness/tingling]], [[heartburn]], [[painful bladder syndrome|painful urination]], and bladder spasms *[[allodynia]] *[[Arthralgia|joint pain]], which may be worsened by [[weight gain]] causing stress on joints *[[hyperalgesia]] *[[muscle spasm]]s *[[myalgia]] (muscle pain) *[[nerve pain]] (neuropathic pain) Many people with fibromyalgia will have other painful comorbid conditions such as: * tension [[Headache|headaches]] and [[Migraine|migraines]] * [[Temporomandibular joint disorder|temporomandibular joint disorders]] (TMJ) * [[rheumatoid arthritis]] (RA) * [[Systemic lupus erythematosus|lupus]] * [[Sjögren's syndrome]] * [[ankylosing spondylitis]] * [[irritable bowel syndrome]] (IBS) * [[menstrual cycle]] cramps and [[interstitial cystitis]] <ref name="ACR2010" /><ref name=":0" /><ref>{{Cite web|url=https://www.health.com/health/gallery/0,,20520705,00.html| title = 7 Conditions Linked to Fibromyalgia | last = Mann | first = Denise | authorlink= | date = Sep 7, 2011 | website = Health.com|language=en|archive-url=|archive-date=|url-status=|access-date=2019-05-03}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14= John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24= Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
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