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Abstract
Objectives: The trigger points [TrPs] of the myofascial pain syndromes [MPS] and the tender points [TePs] of fibromyalgia syndrome [FS] are essential to the diagnosis of these chronic musculoskeletal pain syndromes. However, the relationship between these two syndromes, if any, remains unclear. This study was intended to determine the incidence of trigger points in painful muscles of patients with either fibromyalgia syndrome or a regional pain syndrome [RPS]. In addition specific assessment of all the predesignated tender point sites was performed in order to further assess the relationship between these two clinical signs which characterize FS and MPS respectively. Methods: Sixty well characterized patients with FS, sixty with RPS and sixty control subjects were assessed for the presence of the clinical features of TrPs in all painful muscles and all tender point areas. Results: At least one trigger point was found in forty-one [68.3%] FS patients, thirty-four [56.6%] RPS patients, and twelve controls [20%]. No patients had more than three TrPs. There was no significant difference in the total number of TrPs found at the TeP sites between FS and RPS patients. TrPs, when present, predominantly accounted for regional symptomatology in the posterior muscles of the shoulder. The total number of TrPs in the FS [66], RPS [51], and control [12] groups contrasted with the total number of TePs, respectively 936, 366, and 144. Conclusions: Multiple TrPs could not account for the presence of the numerous TePs found in FS and RPS patients. FS or RPS, as defined here, do not appear to be explained by myofascial pain syndromes.