Measuring Fibromyalgia: Algotensiometry

Dr. J. B. Eisinger and his team in Toulon, France, have discovered a noninvasive, simple, reliable and inexpensive way to screen for fibromyalgia syndrome (FMS).  Using a blood pressure apparatus, they have found a correlation between sensitivity to cuff pressure and the number of FMS tender points.  This process is called algotensiometry, and the minimal systolic value generating immediate local pain is called Tensiometer Induced Myalgia (TIM).  Their results indicate that TIM is decreased in patients with 11 or more tender points ^[1].  TIM is easily repeatable with different examiners ^[2].

The pressure test is usually done on the dominant arm, although it works on either arm.  The FMS patients will experience pain at levels of less than 210 mm Hg.  This pressure should be sustained for no more than 30 seconds.  This test has been shown to be much more reliable than the tender point count ^[2,3].

In a study performed in 61 patients with diffuse muscle pain, researchers found that the mean value of TIM with a blood pressure cuff is significantly decreased in patients with 11 or more of 18 tender points but unchanged in 40 patients with less than 10 tender points.  The tension induced pain is correlated with tender point number and not with spontaneous pain from other causes ^[4].

Co-existing conditions must still be addressed, as must perpetuating factors.  Treatment may be more efficient if medications and therapies take into account the aetiology of each fibromyalgia case ^[5].  Nevertheless, TIM measurement should make it much easier for the clinicians to assess tenderness and objectively determine the presence of FMS.

The Evaluation Form can be seen here with Adobe Reader. 

Doctors who are interested in this approach should contact Dr. Eisinger directly.  

References

1.             1.  Eisinger J, Plantamura A, Camensuli Y, Ayavou T, Zakarian H.  Provoked pain in fibromyalgia syndrome [FMS]: evaluation and correlations.  J. Musculoske Pain 9-5 :110, 2001.  

 2.  Eisinger J, Mechtouf K, Bereder I, Camensuli Y, Marsan E, Plantamura A et al. Reproductibilité de l'algotensiométrie: premiers résultats.  Douleurs 3 (2) : 75-77, 2002. [French]

 3.  Eisinger J.  Evaluation clinique de la fibromyalgie.  Rev Med Int 24 :237-242, 2003. [French]

 4.  Eisinger J.  Seven steps to fibromyalgia.  J. Musculoske Pain 9-3 : 115-122, 2001. 

 5.  Eisinger J, Starlanyl D, Blotman F, Bueno I, Houvenagel E, Juvin R, et al. Protocole d’informations anonyme sur les fibromyalgiques (PIAF).  Lyon Med Med 36 : 9-11, 2000. [French]

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