P. Croft et al., MORE PAIN, MORE TENDER POINTS - IS FIBROMYALGIA JUST ONE END OF A CONTINUOUS-SPECTRUM, Annals of the Rheumatic Diseases, 55(7), 1996, pp. 482-485
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.