MORE PAIN, MORE TENDER POINTS - IS FIBROMYALGIA JUST ONE END OF A CONTINUOUS-SPECTRUM

Objectives-To investigate the hypothesis that fibromyalgia represents one end of a spectrum in which there is a more general association bet ween musculoskeletal pain and tender points. Methods-The subjects stud ied were 177 individuals selected from a population based screening su rvey for musculoskeletal pain. All subjects completed a pain mannikin and were examined for the presence of tender points at the nine Americ an College of Rheumatology bilateral sites. Results-There were moderat ely strong associations (odds ratios range 1.3-3.1) between the report ed presence of pain in a body segment and the presence of a tender poi nt within that segment. Further, there was evidence of a trend of incr easing number of tender points with increasing number of painful segme nts. The reporting of non-specific pain, aching, or stiffness, was als o associated with high tender point counts. Conclusion-This study illu strates that the association between tender points and pain is not res tricted to the clinically defined subgroup with chronic widespread pai n. Given that widespread pain and tender points have previously been l inked with distress, this might reflect lesser degrees or earlier phas es of the somatisation of distress.