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Fibromyalgia's original description as "rheumatism with hard and tender places" has certainly been forgotten. The current method of assessing progress by locating tender points in a few preordained parts of the body has very limited value compared to a total body mapping. A mapper uses moderate finger pressure to find swellings within muscles, tendons and ligaments. Their location, size and degree of hardness is recorded on a body caricature before initiating treatment as a baseline for future comparisons. (See figure) Painful areas that cannot be palpated are not included since they are subjective and vary greatly from day to day. Rather, only the abnormalities that can be felt are noted, so this becomes a pure objective exercise. Previous maps are hidden until the examination is completed and only then are comparisons made. Such visual records display progressive changes on the patient's road to recovery. Patients should also diary variations in their pain, fatigue and emotional swings between visits. The mutual input from patient and mapper make it easier to confirm the regression of the disease.
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