Diagnosis of compressive neuropathies in patients with fibromyalgia

The hand surgeon relies on the Tinel sign in the physical examination of the patient suspected of having a peripheral nerve entrapment. Fibromyalgia is recognized by the American College of Rheumatology as a condition characterized by having tender points on physical examination. This article reviews the location of the 9 bilateral critical diagnostic fibromyalgia points as they relate to known sites of anatomic entrapment of peripheral nerves in the upper extremity. The interpretation of this article is that the Tinel sign may be used with validity to identify the site of a peripheral nerve compression in the upper extremity in the patient with fibromyalgia.