This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Bruce M. Rothschild, MD
Youngstown, Ohio

JAMA. 1993;269(3):355.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Given the scope of the article by Deyo et al,¹ I was surprised that the authors did not discuss fibromyalgia. It may well be the most common cause of low back pain and is identifiable by notation of typical tender "trigger" points.² Pressure, manually applied to specific sites, identifies the presence of such "trigger areas." These sites include the temporalis (above the ear), anterior to the tragus of the ear, scalenus capitis, sternocleidomastoid, low anterior neck, pectoralis minor, manubrium of sternum, anterior and posterior axillary folds, low posterior neck, trapezius ridge, upper and lower rhomboids, parasagittal thoracolumbar spine, iliac crest, mid buttocks, mid vastus lateralis, and the quadriceps insertion at the patella.

While trigger points are not necessarily limited to the low back, low back pain is often the presenting complaint. The pain is often modulated by physical activity, weather changes, anxiety, and stress. It . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?