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More pain, more tender points: is fibromyalgia (FM) just 1 end of a continuous spectrum

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By Croft P, Burt J, Schollum J, Thomas E, Macfarlane G, Silman A • www.ProHealth.com • July 8, 1996


OBJECTIVES: To investigate the hypothesis that fibromyalgia
represents one end of a spectrum in which there is a more
general association between musculoskeletal pain and tender
points.

METHODS: The subjects studied were 177 individuals
selected from a population based screening survey for
musculoskeletal pain. All subjects completed a pain mannikin
and were examined for the presence of tender points at the
nine American College of Rheumatology bilateral sites.

RESULTS: There were moderately strong associations (odds
ratios range 1.3-3.1) between the reported presence of pain in
a body segment and the presence of a tender point within that
segment. Further, there was evidence of a trend of increasing
number of tender points with increasing number of painful
segments. The reporting of non-specific pain, aching, or
stiffness, was also associated with high tender point counts.

CONCLUSION: This study illustrates that the association
between tender points and pain is not restricted to the
clinically defined subgroup with chronic widespread pain.
Given that widespread pain and tender points have previously
been linked with distress, this might reflect lesser degrees,
or earlier phases of the somatisation of distress.




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