Tender Point Index (TPI) in Fibromyalgia

Pressure applied at each point: 4 kilograms (using a pressure dolorimeter)

18 Pressure points - on both left and right sides (2 * 9):

(1) occiput: at the suboccipital muscle insertion

(2) low cervical: at the anterior aspect of the intertransverse spaces at C5-C7

(3) trapezius: at the midpoint of the upper border

(4) supraspinatus: at the origin, above the scapular spine near the medial border

(5) second rib: at the second costochondral junction, just lateral to the junction on the upper surface

(6) lateral epicondyle: 2 cm distal to the epicondyle

(7) gluteal: in the upper outer quadrant of the buttock in the anterior fold of the muscle

(8) greater trochanter: posterior to the trochanteric prominence

(9) knee: at the medial fat pad proximal to the joint line

tender point index =

= SUM(points for all 18 points)

Interpretation:

• minimum score: 0

• maximum score: 72

• The higher the score the more likely the patient has fibromyalgia.