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This study examined fibromyalgia diagnosis trends and associated comorbidities using NAMCS data from 2010-2019, evaluating changes as the American College of Rheumatology's criteria evolved from 1990 to 2016. FM diagnosis increased after the 2010 criteria but decreased significantly following the 2016 revisions. Rheumatoid arthritis (OR 5.51, 95% CI 2.87-10.58) and depression (OR 2.61, 95% CI 1.90-3.58) were strongly associated with fibromyalgia diagnosis, while other comorbidities had minimal associations. The fluctuation in diagnosis post-2016 criteria suggests current criteria may not accurately capture fibromyalgia's complexity, highlighting rheumatoid arthritis and depression as key comorbidities in fibromyalgia diagnosis.
