The prevalence of fibromyalgia varies greatly by population studied and surveillance method used (e.g., survey vs. clinician diagnosed, and criteria used). It is much more prevalent using surveys with standardised criteria (6.4 % vs. 1.1 %, respectively), rather than relying on physician recognition or medical record coding.[7]Vincent A, Lahr BD, Wolfe F, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92.
http://www.ncbi.nlm.nih.gov/pubmed/23203795?tool=bestpractice.com
Prevalence estimates vary greatly with diagnostic criteria applied.[7]Vincent A, Lahr BD, Wolfe F, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92.
http://www.ncbi.nlm.nih.gov/pubmed/23203795?tool=bestpractice.com
[8]Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol. 2015 Feb;67(2):568-75.
https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/art.38905
http://www.ncbi.nlm.nih.gov/pubmed/25323744?tool=bestpractice.com
Fibromyalgia is a common condition worldwide in all ethnic and socio-economic groups.[9]Topbas M, Cakirbay H, Gulec H, et al. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol. 2005 Mar-Apr;34(2):140-4.
http://www.ncbi.nlm.nih.gov/pubmed/16095011?tool=bestpractice.com
[10]Haq SA, Darmawan J, Islam MN, et al. Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study. J Rheumatol. 2005 Feb;32(2):348-53.
http://www.ncbi.nlm.nih.gov/pubmed/15693098?tool=bestpractice.com
[11]White KP, Harth M. Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep. 2001 Aug;5(4):320-9.
http://www.ncbi.nlm.nih.gov/pubmed/11403735?tool=bestpractice.com
[12]Wolfe F. The epidemiology of fibromyalgia. J Musculoskel Pain. 1993;1:137.[13]Raspe H, Baumgartner C, Wolfe F. The prevalence of fibromyalgia in a rural German community: how much difference do criteria make? Arthritis Rheum. 1993;36(9 Suppl):S48. Studies show the prevalence in the general population to be between 0.5% and 5%.[11]White KP, Harth M. Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep. 2001 Aug;5(4):320-9.
http://www.ncbi.nlm.nih.gov/pubmed/11403735?tool=bestpractice.com
The overall prevalence of fibromyalgia in the US, using the 1990 American College of Rheumatology criteria, is around 2%.[12]Wolfe F. The epidemiology of fibromyalgia. J Musculoskel Pain. 1993;1:137. The prevalence is higher in women (3.5%) than in men (0.5%), and 9 out of 10 patients with fibromyalgia are female.[12]Wolfe F. The epidemiology of fibromyalgia. J Musculoskel Pain. 1993;1:137. This bias towards diagnosing almost exclusively females is related to the 1990 fibromyalgia criteria requiring a certain number of tender points (women are inherently more tender than men, so many more will meet these criteria).[8]Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol. 2015 Feb;67(2):568-75.
https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/art.38905
http://www.ncbi.nlm.nih.gov/pubmed/25323744?tool=bestpractice.com
When subsequent criteria (that do not rely on tender points to make the diagnosis) are applied, the female predominance is around 2:1.[7]Vincent A, Lahr BD, Wolfe F, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92.
http://www.ncbi.nlm.nih.gov/pubmed/23203795?tool=bestpractice.com
[8]Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol. 2015 Feb;67(2):568-75.
https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/art.38905
http://www.ncbi.nlm.nih.gov/pubmed/25323744?tool=bestpractice.com
[14]Wolfe F, Clauw DJ, Fitzcharles MA, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011 Jun;38(6):1113-22.
https://www.jrheum.org/content/38/6/1113.long
http://www.ncbi.nlm.nih.gov/pubmed/21285161?tool=bestpractice.com
An increase in the prevalence of fibromyalgia to between 6% and 8% of the population has been reported.[7]Vincent A, Lahr BD, Wolfe F, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92.
http://www.ncbi.nlm.nih.gov/pubmed/23203795?tool=bestpractice.com
[14]Wolfe F, Clauw DJ, Fitzcharles MA, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011 Jun;38(6):1113-22.
https://www.jrheum.org/content/38/6/1113.long
http://www.ncbi.nlm.nih.gov/pubmed/21285161?tool=bestpractice.com
[15]Marques AP, Espírito Santo AS, Berssaneti AA, et al. Prevalence of fibromyalgia: literature review update. Rev Bras Reumatol Engl Ed. 2017 Jul-Aug;57(4):356-63.
https://www.sciencedirect.com/science/article/pii/S2255502117300056
http://www.ncbi.nlm.nih.gov/pubmed/28743363?tool=bestpractice.com
Age of onset is typically between 20 and 60 years, with an average age of 35 years; prevalence increases with age.[11]White KP, Harth M. Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep. 2001 Aug;5(4):320-9.
http://www.ncbi.nlm.nih.gov/pubmed/11403735?tool=bestpractice.com
[12]Wolfe F. The epidemiology of fibromyalgia. J Musculoskel Pain. 1993;1:137. Familial and genetic factors play a strong role; first-degree relatives of individuals with fibromyalgia are eight times more likely to have the condition.[16]Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia. Arthritis Rheum. 2004 Mar;50(3):944-52.
https://onlinelibrary.wiley.com/doi/full/10.1002/art.20042
http://www.ncbi.nlm.nih.gov/pubmed/15022338?tool=bestpractice.com
Fibromyalgia can also present in childhood, but this patient group is not addressed specifically in this topic.