Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome

✍ Scribed by Gerald Granges; Geoffrey Littlejohn

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 446 KB
• Volume: 36
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780360510

✦ Synopsis

Objective. We hypothesized that change in pain threshold to pressure reflects a generalized change in the pain system affecting both tender and control points.

Methods. We assessed 18 tender points and 4 control points using an algometer in 60 patients with generalized fibromyalgialfibrositis syndrome, 60 patients with localized chronic pain syndromes, and in 60 pain-free subjects.

Results. A significant correlation was found between myalgia scores at tender points and control points in these subjects.

Conclusion. These results suggest that there is a diffuse change in pain modulation in fibromyalgia, as hypothesized, but the tender point is still clinically useful.

Assessment of tenderness over multiple predesignated areas allows for identification of patients with fibromyalgia syndrome from among patients with other rheumatic or nonrheumatic conditions, with acceptable accuracy. The elicitation of 11 of 18 possible tender points, together with diffuse pain, discriminates patients with fibromyalgia from patients with other soft tissue disorders (1). Most patients are not overtly symptomatic in areas which constitute these diagnostic tender points. The high number of tender From the Rheumatology Unit, Monash Medical Centre,