No More Tender Points

Fibromyalgia needs to be diagnosed by symptoms and can't be detected with an x-ray. Traditionally diagnosis has been done by examining the level of pain in 18 pressure points. These points are in the following locations:

· Bilateral Trapezius. This is at the top of the deltoid muscles at the midpoint of the upper border

· Bilateral Supraspinatus. This is located where your shoulder blade is near the medial border above the scapular spine.

· Bilateral knees. This is at the medial fat pad proximal to the joint line.

· Bilateral second rib. This is halfway to your breasts under your collar bone. It's just lateral to the upper surfaces of the second costochondral junctions.

· Bilateral occiput. This is located just under your hair line at the back of your head. This location is also known as the suboccipital muscle insertions.

· Bilateral gluteal. This is at the outer top edge of your hip in the upper outer quadrants of the buttocks.

· Bilateral low cervical. This is spaces where your head meets your shoulders.

· Bilateral greater tochanter. This is behind the trochanteric prominence close to the back hip joint.

In findings published in a 2010 issue of Arthritis Care and Research, a new method of diagnosing fibromyalgia was reported. The new criteria have been approved by the American College of Rheumatology. Traditionally a diagnosis was made if a patient experienced tenderness in 11 of the 18 pressure points when touched as well as experiencing overall pain for three months in four quadrants of the body. But research has shown that the tender point exams aren't entirely accurate since the pain in the points can fluctuate over time.

The New Testing

With this new published method of fibromyalgia diagnosis, tender points and tender point exams were completely avoided. A symptom severity scale along with a widespread pain index was used instead. With the pain index, a person records the number of body parts that caused them pain over the last week. Then the doctor compares the pain with a 19-item checklist. The symptoms are assessed in an ascending scale of severity with zero being the mildest and three being the most severe. Experts suspect the new criteria could lead to better diagnosis and possibly an increase in the number of people officially diagnosed with fibromyalgia.

Problems With the Older Criteria

The older criteria were never meant to be used as a way to diagnose fibromyalgia, according to Dr. Daniel J. Clauw, a well-known speaker about fibromyalgia and rheumatologist at the University of Michigan in Ann Arbor. The doctor says it was only meant to be used to help standardize research into the condition. Dr. Clauw was instrumental in developing the new criteria.


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