Fibromyalgia/Pressure
Pain Threshold (FM/PPT) Test©
This
document provides background information on the underlying principles
behind the Fibromyalgia/Pressure Pain Threshold (FM/PPT) test.
Soft
Tissue Pain
Soft tissue pain (or muscular pain) is extremely common among
people with musculoskeletal problems, especially if the problems
are chronic. It contributes to the pain that patients with a
wide range of musculoskeletal problems experience. For example,
many patients with vertebral subluxations also demonstrate clinical
evidence of muscular pain.
Various
terms have been used to describe syndromes in which pain seems
to emanate from muscles and patients demonstrate tenderness
on examination. One such term is "myofascial pain syndrome,"
another is "fibromyalgia." There have been many debates
over the years about the similarities and differences between
these two terms.
Myofascial
Pain
Myofascial pain has been discussed by physicians for almost
100 years. The most comprehensive discussion of myofascial pain
is contained in Myofascial Pain and Dysfunction: The Trigger
Point Manual. As discussed in this text, the hallmark of myofascial
pain is the presence of one or more trigger points in muscles.
The authors assert that trigger points are tender, but that
other clinical findings are also typically present, and help
an examiner identify a site as a trigger point. Specifically,
they say that palpation of a trigger point produces not only
local tenderness but also a characteristic pattern of referred
pain. Also, taut bands of muscle can be palpated when a trigger
point is present, and stimulation of these bands elicits a local
twitch response from a portion of the muscle being examined.
Myofascial
pain is often local or regional, although it can be very widespread.
Fibromyalgia
Fibromyalgia
(FM) has a very different history. It is a concept developed relatively
recently by rheumatologists to describe patients who presented
with widespread pain and muscular tenderness, but did not demonstrate
abnormalities that suggested any other rheumatologic disorder.
1. Robinson, J. and McCoy, H. Fibromyalgia/Pressure
Pain Threshold (FM/PPT) test © 2002.
2.
Travell, J. G. and Simons, D. G. Myofascial Pain and Dysfunction:
the Trigger Point Manual. Baltimore: Williams & Wilkins,
1983.
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