Background/Purpose:  To determine whether: 1)  patients with the fibromyalgia syndrome (FMS) can accurately evaluate their own tender points, similar to self-administered testing for other purposes (blood pressure and glucose), and 2) whether this might be helpful for monitoring the illness.

Methods: We enrolled 24 patients with a known diagnosis of FMS (meeting the 2010 ACR criteria) and 27 healthy controls. Dolorimetry was performed on each patient by a rheumatology nurse, who also instructed the patient in self-dolorimetry using a pressure gauge smaller than a standard dolorimeter, (Wagner Force Dial FDK/FDN Series Push Pull Force Gage).

Tender points were assessed using self-administered dolorimetry. Tender points were checked at 8 paired fibromyalgia tender point areas: occiput, lower cervical spine, chest wall, lateral epicondyles, knees, trapezius muscles, gluteus muscles, and greater femoral trochanters.

Results: FM patients’ ages were 45 y.o. +/-20, 18F and 10M. Normal controls ages were 48 y.o. +/-15, 15F and 10M. Self-measured dolorimetry readings for fibromyalgia patients ranged from 3-20 pounds of pressure and for normal controls from 10-30. When we compared readings performed by a nurse with those done by patients, there were no significant differences.  Dolorimetry exams of the trapezius muscle yielded the following results: 32 FMS patients recorded a mean reading of 5.86 pounds per pressure, while 32 controls had a mean reading of 12.05 pounds per pressure.  

Conclusion: Using self-administered dolorimetry, our results show that tender points can be measured by patients easily and with reasonable accuracy.  The sites providing the best discrimination between patients and controls were the occiput, trapezius muscles, and gluteal muscles. Currently, clinician rated VAS scales are used to monitor the efficacy of treatment in FMS. Self-administered dolorimetry may also allow patients to assess treatment efficacy.  This method of home monitoring would be a convient and inexpensive option for patients to monitor flares of disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/home-tender-point-measurement-in-fibromyalgia-patients/