1. History of Widespread Pain
Pain is considered widespread when all of the following are present : pain in the left side of the body, pain in the right side of the body, pain above the waist and pain below the waist. In addition there should be pain in the spine or the neck or front of the chest, or thoracic spine or low back.

2. Pain in 11 of 18 Tender Point Sites on Finger Pressure
There should be pain on pressure (around 4kg of pressure maximum) on not less than 11 of the following sites:

• Either side of the base of the skull where the subocciptal muscles insert.

• Either side of the side of the neck between the 5th and 7th cervical vertebra, technically described as between the ‘anterior aspects of inter-transverse spaces’.

• Either side of the body on the midpoint of the muscle which runs from the neck to the shoulder (upper trapezius)

• Either side of the body on the origin of the supraspinatus muscle which runs along the upper border of the shoulder blade.

• Either side, on the upper surface of the rib, where the second rib meets the breast bone, in the pectoral muscle.

• On the outer aspect of either elbow just below the prominence (epicondyle)

• In the large buttock muscles, either side, on the upper outer aspect in the fold in front of the muscle (gluteus medius)

• Just behind the large prominence of either hip joint in the

• On either knee in the fatty pad just above the inner aspect of the joint.