Affiliations: [a] Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Bronx, New York, USA | [b] Department of Rehabilitation Medicine, Mt. Sinai School of Medicine (CUNY), New York, USA
Correspondence:
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Physical Medicine & Rehabilitation Service, V.A. Medical Center (117), 130 W. Kingsbridge Road, Bronx, New York 10468, USA. Tel.: + 1 718 5791609/516 8299337; fax: + 1 718 5794082/516 8299332.
Abstract: Purpose:This is a review article to update the clinical applications of pressure pain sensitivity (PPS) measurement by pressure algometry (PA) [1,2]. Basic procedures:The basic literature on pressure algometry has been reviewed with emphasis on new developments. The author’s and his co-workers’ experience with PA, extending several years, are also included along with some unpublished research results. Findings:The high reliability and validity of PA for quantification of PPS has been proven by several authors. The specificity and sensitivity of PA in detection of trigger points (TrPs) is also very good. PA is also useful in evaluation of treatment results. PA can document the decreased PPS after âĂŸpreinjection (regional) blocks’ administered prior to trigger point injections (TPIs). A study of ten patients with failed back surgery included 20 muscles. PA documented long-term improvement (150 days) which corresponded to a decrease in pain rating. Treatment consisted of needling and infiltration of the entire trigger point (TrP) extending to taut band. Another study showed that physicians were unable to produce 4 kg of pressure, which is critical for diagnosis of fibromyalgia. Conclusions:Quantification of fibromyalgia diagnosis by PA is necessary for abnormal tenderness (pain on 4 kg pressure). The critical pressure for TrP, tender spots is a pressure pain threshold lower by 2 kg/cm2 relative to a normally sensitive corresponding control point.
