Primary: The patient presents generalized musculoskeletal pain and multiple tender points but there is no clinical evidence of another disease that can explain these symptoms.
Concomitant: Fibromyalgia presents at the same time another condition that can only partially explain the symptoms. For example, in a patient with osteoarthritis, the localized pain symptom may be explained, but not the diffuse pain.
Secondary: When it happens to suffer from a rheumatic, immunological or infectious disease for example and fibromyalgia also occurs.
Degrees of Fibromyalgia:
Grade 1: The person has occasional or oscillating symptoms without significant limitation in working life and activities of daily life. It only presents functional limitations in some moments of its activity, especially when overloading physical or mental efforts. It allows to make a life as normal: with some limitations. It may be necessary to adapt certain aspects in the workplace to avoid overload or very long activities. VITAL AFFECTION: MILD. Clinical assessment stairs with scores lower than 50%. No interference with work.
Grade 2: Presence of fatigue more persistent. Occasionally it can be intense. It is necessary to reduce the work activity, as well as the intense domestic, personal or social activities of the person. It may require temporary work absences and probably change of position or reduction of working hours. May require assistance for the performance of intense activities or tasks. All types of activity of the person that are reduced to 50% of their normal capacity. VITAL AFFECTION: MODERATE. Clinical assessment stairs between 50 and 75%. Interference with the function or work (partial loss of activity) ..
Grade 3: Fatigue is marked and intense at every moment. It does not allow to execute any type of activity that is minimally intense or continuous. It affects all aspects of the life of the work person, domestic and leisure. It is not compatible with a regular work activity. Activities can only be carried out in short periods (almost always less than 30 minutes in a row.) The autonomy and activities are limited to 80% VITAL AFFECTION: INTENSE (SEVERE) Clinical assessment stairs greater than 75% Marked interference with function or work (impossibility to carry out activity, work or situation of sick leave due to disability).
Grade 4: Extreme fatigue. It requires the help of other people even for basic personal activities and temporarily loses autonomy. In this phase there may be a situation of dependency and a great need for help. It coincides with periods of exacerbation of symptoms of the disease. It is not usually a fixed or permanent situation. The patient manages to make only minimal efforts. He’s in bed or on a couch every day. Autonomy is limited to 100%.