The Symptom Severity Score (SSS) is a key component in the evaluation and diagnosis of fibromyalgia, as outlined in standard medical references. It is part of the criteria established by the American College of Rheumatology (ACR), particularly in the guidelines updated in 2010.
Components of the Symptom Severity Score:
The SSS assesses the severity of various symptoms associated with fibromyalgia, typically focusing on the following areas:
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Widespread Pain Index (WPI): This part measures the number of painful regions in the body. Patients indicate whether they have experienced pain in specific areas within the past week, and the number of positive responses contributes to the score.
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Symptom Severity: This is evaluated based on the severity of three specific symptoms over the past week:
- Fatigue
- Sleep disturbances
- Cognitive difficulties (often referred to as "fibro fog")
Patients rate the severity of each of these symptoms on a scale, typically from 0 to 3:
- 0 = No problem
- 1 = Mild (slight problem)
- 2 = Moderate (pretty significant problem)
- 3 = Severe (very significant problem)
Scoring:
- The WPI score can range from 0 to 19, depending on how many areas of pain are reported.
- The Symptom Severity score can range from 0 to 9, based on the ratings of the three key symptoms.
Interpretation:
To meet the criteria for fibromyalgia, a patient typically needs:
- A WPI score of 7 or more (indicating widespread pain) or a WPI score of 3 to 6 with a Symptom Severity score of 5 or more.
- A duration of symptoms of at least three months.
This scoring mechanism helps healthcare providers objectively assess the severity of fibromyalgia symptoms and aids in diagnosis and treatment planning.