PRESSURE-CONTROLLED PALPATION - A NEW TECHNIQUE WHICH INCREASES THE RELIABILITY OF MANUAL PALPATION

The objective of the present study was to investigate whether the reli ability of tenderness evaluation can be increased by using a new techn ique called ''pressure-controlled palpation'' (pcp). The technique has been made possible by a newly invented piece of equipment called a pa lpometer, with which a pressure-sensitive plastic film attached to the index finger records the pressure exerted. In 15 patients with chroni c tension-type headache and in 15 healthy volunteers, 2 investigators studied myofascial tenderness using conventional palpation and pressur e-controlled palpation. Tenderness was scored on a 4-point scare in ea ch of the examined pericranial regions. The sum of tenderness scores r ecorded by two observers using conventional palpation differed signifi cantly (p = 0.0003), while results did not differ between observers us ing pressure-controlled palpation (p = 0.89). During palpation with se ven different pressure intensities a positive and linear relation betw een pressure and pain intensity was found (p = 0.00006). Pain intensit y reported by the subjects correlated highly with tenderness scored by the observer (r(s) = 0.95, p < 0.0001). These results demonstrate for the first time that tenderness scores can be compared between observe rs if palpation pressure is controlled pressure-controlled palpation r epresents a major improvement on current palpation techniques and shou ld be standard in future research on myofascial pain disorders.