Symptom Severity Scale (SSS) and Widespread pain index (WPI) Calculator

WPI

Note the number of areas where the patient has had pain in the previous week. In how many areas did the patient feel pain?

Symptom severity scale (SSS, 2A+2B)

Intensity of the 3 symptoms (2A)

For each of the 3 symptoms, indicate the level of severity during the previous week.

Fatigue
Drowsiness
Cognitive symptoms

Number of associated symptoms (2B)

Considering somatic symptoms in general, indicate if the patient has experienced during the past week:



WPI :

SSS : 2A : - 2B :

Total SSS:

Criterion 1 Fibromyalgia :

Overview of the SSS and WPI Calculator

The Symptom Severity Scale (SSS) and Widespread Pain Index (WPI) Calculator is a user-friendly digital tool developed to help individuals assess symptoms commonly associated with fibromyalgia. Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive issues. Because the symptoms can be varied and subjective, this calculator offers a structured method to capture symptom patterns and severity in a consistent way.

The WPI component focuses on identifying the number of areas on the body where the user has experienced pain during the past week. It helps in recognizing the extent and distribution of pain across different zones. The SSS component complements this by evaluating the intensity of key symptoms such as fatigue, unrefreshing sleep, and cognitive difficulties, as well as noting the presence of other somatic symptoms like headaches, digestive problems, or sensitivity to light. The final result provides an objective score that can support diagnosis and treatment planning.

Purpose of the Calculator

The primary purpose of the SSS and WPI Calculator is to offer a standardized, self-guided way to assess and document symptoms related to fibromyalgia. While it does not replace a medical diagnosis, it serves as a valuable tool for both patients and healthcare providers. This calculator helps users to:

  • Quantify widespread pain: Users can report the specific areas of the body where they’ve experienced pain in the last 7 days. This information forms the WPI score, which is a key component in assessing fibromyalgia.
  • Measure symptom severity: The SSS section enables users to evaluate how strongly they are affected by symptoms like fatigue, drowsiness, and cognitive issues. These are core indicators of the impact fibromyalgia can have on daily life.
  • Identify associated symptoms: A checklist of somatic symptoms allows users to document other physical complaints that may contribute to or worsen their condition.
  • Determine diagnostic compatibility: The calculator automatically processes the input to indicate whether the results meet the commonly accepted criteria for a fibromyalgia diagnosis, which can then be discussed with a healthcare professional.

In summary, this tool empowers users to better understand their symptoms, track their health over time, and prepare for more informed conversations with doctors. It supports early detection, ongoing monitoring, and personalized care strategies for managing fibromyalgia.

Widespread Pain Index (WPI)

Explanation of the WPI

The Widespread Pain Index (WPI) is a measure used to determine how many areas of the body a person has experienced pain in over the past week. It is one of the two main criteria used in the assessment of fibromyalgia. The index includes 19 specific areas on the body, and the user is asked to indicate whether they have felt pain in each of those areas recently. Each positive response adds one point to the total WPI score.

A higher WPI score reflects a greater number of pain areas, which may indicate a more widespread and systemic issue. The WPI is essential for recognizing the distribution of pain and contributes significantly to the overall evaluation when combined with the Symptom Severity Scale (SSS).

How to Identify Pain Zones

To accurately complete the WPI section, you need to consider any pain you've experienced during the past 7 days. Pain zones include areas such as:

  • Shoulders (left and right)
  • Upper arms and lower arms (left and right)
  • Hips and upper legs (left and right)
  • Lower legs (left and right)
  • Jaw (left and right)
  • Chest, neck, upper back, lower back, and abdomen

If you've felt pain in a specific zone, even intermittently, it should be counted. Pain does not need to be constant or severe to qualify. A visual aid is often provided in the calculator to help you locate each of the 19 zones on the body.

Step-by-Step Guide to Entering Pain Zones in the Calculator

  1. Look at the provided body diagram labeled with the 19 pain zones.
  2. Review your experience over the past week and note every area where you've had pain.
  3. Count the total number of zones where pain was present.
  4. In the calculator form, find the field labeled "Number of zones".
  5. Enter the total number (between 0 and 19) in the input box.
  6. The calculator will automatically use this number to calculate your WPI score when you press "Calculate."

Once entered, your WPI score will appear in the results section and be used to help determine whether your symptoms align with fibromyalgia criteria.

Symptom Severity Scale (SSS)

Overview of the Symptom Severity Scale

The Symptom Severity Scale (SSS) is a scoring system designed to measure the intensity and impact of three primary symptoms often associated with fibromyalgia: fatigue, sleep disturbances (drowsiness), and cognitive issues (such as memory or concentration problems). In addition, it considers the number of other physical symptoms (somatic symptoms) present during the previous week.

The SSS score is made up of two parts:

  • Part 2A: Rates the severity of fatigue, sleep quality, and cognitive symptoms on a scale from 0 to 3.
  • Part 2B: Counts the number of additional somatic symptoms and converts them into a score from 0 to 3 based on how many are selected.

Together, the two parts produce a total score ranging from 0 to 12. This score helps determine the extent to which symptoms are affecting your daily life and contributes to the overall assessment of fibromyalgia.

Detailed Instructions for Each Symptom Category

Fatigue

Think about how tired or exhausted you have felt over the past week. This refers to physical and mental fatigue, whether it was mild or strong, temporary or persistent. Select the option that best matches your experience:

  • 0: No problem
  • 1: Mild or moderate problems, usually moderate or intermittent
  • 2: Moderate, considerable, often present and/or moderate level problems
  • 3: Significant, persistent, continuous, disabling problems on a daily basis

Sleep Quality (Drowsiness)

This refers to how well you’ve been sleeping and how refreshed you feel upon waking. Consider whether you feel rested in the morning and if drowsiness affects your ability to function during the day. Choose the option that best describes your sleep issues in the last week:

  • 0: No problem
  • 1: Mild or moderate problems, usually moderate or intermittent
  • 2: Moderate, considerable, often present and/or moderate level problems
  • 3: Significant, persistent, continuous, disabling problems on a daily basis

Cognitive Symptoms

This includes difficulties with memory, concentration, mental clarity, or staying focused. These issues are sometimes described as "fibro fog." Reflect on whether you’ve had trouble with mental tasks over the last week and select the option that fits your situation:

  • 0: No problem
  • 1: Mild or moderate problems, usually moderate or intermittent
  • 2: Moderate, considerable, often present and/or moderate level problems
  • 3: Significant, persistent, continuous, disabling problems on a daily basis

After selecting your answers for all three symptoms, the calculator will total your scores and display the result for Part 2A. This, combined with the somatic symptom count from Part 2B, forms your overall SSS score.

Rating Associated Symptoms (2B)

Explanation of Additional Symptoms

The second part of the Symptom Severity Scale, known as 2B, focuses on the presence of additional physical symptoms, often referred to as somatic symptoms. These are various health complaints that may not be directly related to pain but can significantly affect a person's well-being. Individuals with fibromyalgia often report a wide range of such symptoms, and recognizing them helps provide a fuller picture of the condition's impact.

In the calculator, you are presented with a checklist of 41 possible associated symptoms. These symptoms range from digestive issues and skin problems to neurological complaints and general discomforts. The total number of symptoms checked is used to calculate a score from 0 to 3:

  • 0 points: Few or no symptoms checked
  • 1 point: Some symptoms (1–10)
  • 2 points: Moderate number of symptoms (11–24)
  • 3 points: Many symptoms (25 or more)

How to Record the Severity of Additional Symptoms

You do not need to rate the severity of each individual symptom. Instead, simply go through the list and check every symptom that you have experienced during the past week. It does not matter how intense the symptom was—if it was present at all, it should be marked.

Once all relevant symptoms are selected, the calculator automatically counts them and assigns a corresponding score from 0 to 3. This score becomes your 2B result, which is then added to your 2A score to produce your total SSS score.

List and Explanation of All Associated Symptoms

Below is a list of all the associated symptoms included in the calculator. These may vary in intensity and frequency from person to person, but all are considered relevant when evaluating fibromyalgia:

  • Muscle aches
  • Memory or concentration problems
  • Muscular weakness
  • Insomnia
  • Constipation
  • Chest pain
  • Blurred vision
  • Respiratory wheeze
  • Tinnitus (ringing in the ears)
  • Mouth ulcers
  • Dry eyes
  • Skin rash
  • Easy bruises
  • Painful urination
  • Irritable bowel syndrome
  • Headaches
  • Numbness or tingling
  • Depression
  • Upper abdominal pain
  • Diarrhea
  • Fever
  • Raynaud’s Syndrome (cold, discolored fingers/toes)
  • Vomiting
  • Loss or change of taste
  • Respiratory tightness
  • Hypersensitivity to the sun
  • Hair loss
  • Bladder spasms
  • Fatigue (in addition to main fatigue rating)
  • Abdominal pain or cramps
  • Dizziness
  • Nervousness
  • Nausea
  • Dry mouth
  • Itching
  • Urticaria (hives)
  • Chest burn (heartburn)
  • Epileptic crisis
  • Loss of appetite
  • Hearing disorder
  • Frequent urination

Each symptom you’ve experienced helps to build a more complete and accurate assessment. Be honest and thorough when checking symptoms to ensure your SSS score truly reflects your condition.

Calculating the Results

How the Calculator Processes Input Data

Once you've entered your pain zones (WPI) and selected the severity of symptoms (SSS), the calculator automatically processes the information using a simple scoring algorithm. It gathers values from each section:

  • WPI: Based on the number of pain zones selected (0–19).
  • SSS Part 2A: Adds the scores from fatigue, sleep quality, and cognitive symptoms (0–9).
  • SSS Part 2B: Counts the number of additional symptoms and converts the total to a score from 0 to 3.

The total SSS score is then calculated by combining 2A and 2B (maximum score = 12). The calculator also determines whether your results meet the criteria for a possible diagnosis of fibromyalgia.

Understanding the Output Values

After pressing the "Calculate" button, your results will appear as follows:

  • WPI: The number of pain areas marked (0–19).
  • SSS – 2A: Sum of severity ratings for fatigue, drowsiness, and cognitive symptoms (0–9).
  • SSS – 2B: A score from 0–3 based on how many additional symptoms were checked.
  • Total SSS: The sum of 2A and 2B scores (0–12).
  • Criterion 1 – Fibromyalgia: Displays “Yes” if your combined results meet the clinical criteria, or “No” if they do not.

Criteria for Diagnosis of Fibromyalgia Based on the Calculator’s Results

According to the American College of Rheumatology (2010) criteria, a person is considered to meet the diagnostic standard for fibromyalgia if one of the following conditions is met:

  • WPI ≥ 7 and SSS ≥ 5
  • WPI between 3–6 and SSS ≥ 9

If your results match either of the conditions above, the calculator will display "Yes" next to the “Criterion 1 – Fibromyalgia” output. This does not confirm a diagnosis but suggests that your symptoms are consistent with fibromyalgia and should be discussed with a healthcare provider.

The calculator is intended to guide awareness, not replace professional medical advice. Always consult a qualified health professional for an official diagnosis and treatment plan.

FAQs

What is the SSS and WPI Calculator used for?

The SSS and WPI Calculator is a tool designed to help individuals assess symptoms related to fibromyalgia. It allows users to input their pain areas and symptom severity to receive a calculated score that may indicate whether they meet the criteria for fibromyalgia.

Can this calculator diagnose fibromyalgia?

No. This calculator cannot provide a medical diagnosis. It is a self-assessment tool meant to guide users in understanding their symptoms. A diagnosis should only be made by a licensed healthcare professional based on clinical evaluation and medical history.

What does WPI stand for?

WPI stands for Widespread Pain Index. It measures how many specific areas of the body experienced pain in the past 7 days, with a maximum score of 19.

What does SSS stand for?

SSS stands for Symptom Severity Scale. It includes the severity of three core symptoms—fatigue, drowsiness, and cognitive problems—as well as a score for additional physical symptoms.

How do I know which areas to count in the WPI?

Use the body diagram provided in the calculator to identify the 19 specific zones. If you’ve experienced pain in a zone during the past week, count it—even if the pain was mild or occasional.

Do I need to rate every symptom in SSS Part 2B?

No. In Part 2B, simply check the box next to any symptom you’ve experienced in the past week. The calculator will automatically assign a score based on the total number of symptoms checked.

What is a “normal” score?

There is no “normal” score, as the calculator is designed to help identify patterns and severity of symptoms rather than evaluate health in general. However, a higher total score, especially when combined with a high WPI, may indicate fibromyalgia-like symptoms.

Can I use this tool to monitor my symptoms over time?

Yes! You can use the calculator regularly to track your symptoms and see how they change. This can be helpful for monitoring progress, understanding symptom triggers, and sharing information with your doctor.

What should I do if my result says “Yes” for fibromyalgia?

If your result indicates that your symptoms meet the criteria for fibromyalgia, it is important to schedule an appointment with a healthcare provider. They can conduct a full evaluation and determine the appropriate next steps for diagnosis and treatment.

Is my information saved?

No personal information is saved by this calculator. Your results are calculated and displayed immediately in your browser but are not stored or sent anywhere unless you choose to share them yourself.

Glossary

Fibromyalgia: A chronic medical condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. It is often accompanied by other symptoms such as headaches, irritable bowel syndrome, and depression.

Widespread Pain Index (WPI): A scoring tool that counts the number of specific areas on the body where the patient has felt pain during the past 7 days. The maximum score is 19.

Symptom Severity Scale (SSS): A scale that measures the intensity of three core symptoms (fatigue, drowsiness, and cognitive issues) and includes a score for additional associated symptoms. The total score ranges from 0 to 12.

Somatic Symptoms: Physical symptoms that may not have a clear medical explanation but are commonly reported in conditions like fibromyalgia. These include symptoms such as dizziness, skin rashes, headaches, and gastrointestinal issues.

Cognitive Symptoms: Problems related to thinking, memory, and concentration—often referred to as “fibro fog” by people with fibromyalgia.

Drowsiness (Sleep Disturbances): Difficulty staying awake, unrefreshing sleep, or constant tiredness during the day, which are common in people with fibromyalgia.

Fatigue: A constant or recurring feeling of exhaustion or tiredness that does not improve with rest. It is one of the core symptoms of fibromyalgia.

Criterion 1 – Fibromyalgia: The diagnostic condition based on the combination of WPI and SSS scores. A person may meet the criteria if WPI ≥ 7 and SSS ≥ 5, or if WPI is 3–6 and SSS ≥ 9.

2A (SSS Part 2A): The part of the SSS that includes severity ratings for fatigue, sleep quality, and cognitive symptoms (each scored 0–3).

2B (SSS Part 2B): The part of the SSS that accounts for the number of additional physical symptoms experienced, contributing a score from 0 to 3.

Self-Assessment Tool: An interactive resource that allows users to input their symptoms and receive an automated calculation or evaluation. It is not a substitute for professional medical advice or diagnosis.

References from Books

  • Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Häuser, W., Katz, R. S., Mease, P., Russell, A. S., Russell, I. J., & Walitt, B. (2010). The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. In: Arthritis Care & Research, 62(5), 600–610. (Also included in several rheumatology textbooks.)
  • Clauw, Daniel J. Fibromyalgia and Other Central Pain Syndromes. In: Hochberg, M.C., Silman, A.J., Smolen, J.S., Weinblatt, M.E., & Weisman, M.H. (Eds.) Rheumatology. 5th Edition. Mosby Elsevier, 2011.
  • Liptan, Ginevra. The FibroManual: A Complete Fibromyalgia Treatment Guide for You and Your Doctor. Ballantine Books, 2016.
  • Bennett, Robert M. Rheumatology Secrets. 3rd Edition. Elsevier Health Sciences, 2009.
  • Wallace, Daniel J., and Clauw, Daniel J. Fibromyalgia and Other Central Pain Syndromes. Springer, 2005.