Table 1. Manual Tender Point Survey
Î Instruct patient that various areas of the body will be examined and to say Yes or No if pain is felt at specific points.
Î Ask patient to rate the intensity of pain on a scale from 0 to 10, where 0 is no pain and 10 is the worst pain ever experienced.
Î Assess the presence and intensity of pain at 18 survey and 3 control sites: Survey and Control Sites
Seated
Mid-Forehead Occiput Trapezius
Supraspinatus Gluteal
Low Cervical 2nd Rib
Bilateral Epicondyle Dorsum R Forearm L Thumbnail
Side Greater Trochanter
Supine Knee
Positive Survey Sites: Positive Control Sites:
Fibromyalgia Intensity Score (SS/18): Control Intensity Score (CS/3):
Table 2. How to Distinguish Myofascial Pain Syndrome (MPS) From Fibromyalgia7
Feature Myofascial Pain Syndrome Fibromyalgia
Trigger/Tender points Few, localized trigger points Musculoskeletal pain Localized Taut band
Seen
Twitch response Referred pain Fatigue
Poor sleep Paresthesia Headache
Irritable bowel Normal
More frequent Less frequent Less frequent Less frequent Less frequent Less frequent
Sensation of swelling Less frequent
Multiple, generalized tender pts Generalized May be seen Normal
Less frequent More frequent More frequent More frequent More frequent More frequent More frequent
Right
1. (control site) 2. 4. 6. 8.
10. 12. 14.
16. (control site) 17. (control site) 18. 20. 19. 21.
Total Survey Site Scores (SS): Total Control Site Scores (CS):
3. 5. 7. 9.
11. 13. 15.
Leſt
