How is the manual tender-point survey (MTPS) scored in the physical exam of fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Pain scores from each of the 18 tender-point sites can be averaged to yield a Fibromyalgia Intensity Score (FIS) that varies from 0-10, with higher scores indicating more severe tenderness. The FIS can be monitored over time to evaluate response to therapy.

It is important to emphasize that pain upon light pressure may not be restricted to specific tender points. Many patients feel pain virtually anywhere that pressure is applied, including at the control points (eg, forehead, thumbnail, and distal right forearm) that are relatively insensitive to pain in healthy patients. Pain to palpation at control points should not be considered abnormal in fibromyalgia patients and should not be taken as proof that the patient is "faking" the examination.

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