Fibromyalgia Tender Points
• What Are Tender Points?
Back To Main Guide
|What Are Tender Points?
These are tender spots on the body, located around joints (but not the joints themselves), which hurt when pressed with a finger. Although these spots may also be sensitive in healthy people, they are much tenderer in people with fibromyalgia, which is why they are an important diagnostic tool. The American College of Rheumatology has charted 18 tender points. They have issued the following guidelines to doctors for diagnosing fibromyalgia:
1. Pain must be experienced in at least 11 of the specified tender points when touched with a force of 9 pounds or less.
When a doctor tests for fibromyalgia they check the tender points using a special instrument called a dolorimeter (which exerts the right amount of pressure for testing pain threshold and tolerance). Usually they also check ‘control’ points. These are non-tender points on the body which should not react to pressure (if they do, another condition may be responsible for pain). Read about fibromyalgia diagnosis for more details.
The only problem with this test is that fibromyalgia is a changeable syndrome; people tend to have good days and bad days. At the time of a doctor's appointment maybe only 8 tender points for example react, but the following week all 18 could flare up. If a doctor is particularly rigid in their diagnosis, fibromyalgia will not be diagnosed. This is why it is important to tell your doctor about any other fibromyalgia symptoms you may be suffering such as depression, sleeping problems, irritable bowel syndrome or interstitial cystitis.
Tender points are not large areas of pain, but spots about the size of a thumb mark. The particular spots can make a patient flinch in pain. Generally you do not need to press deeply for a reaction, tender points are almost superficial on the surface.
There are 18 identified tender points, 9 pairs, one located on each side of the body. These are:
• On the neck muscles at the base of the skull.
Scientists are still not sure what causes tender points. Even though patients may feel the muscle area is inflamed, researchers have not found any evidence of inflammation or tissue damage. What is known however is that tender points are not random, they occur in predictable places on the body and most people with fibromyalgia experience very similar symptoms. See also fibromyalgia causes.
Myofascial pain syndrome (MFS) is a condition which may be confused with fibromyalgia. However the type of pain a patient experiences with MFS is normally located to one area, whereas fibromyalgia is characterized by widespread pain throughout the body. In 90 percent of cases MFS pain occurs in a fibromyalgia tender point. When pressed, you can normally feel a lumpy, tight knot which triggers pain out into other regions of the body. This is why it is called a trigger point. You are unlikely to feel anything unusual (outside of pain!) when you touch the same spot in a fibromyalgia patient. The discovery that tender points are actually trigger points is good news for a patient in one way, as trigger points respond well to massage and heat therapy (such as soaking in a hot tub).
The pain produced by tender points can be managed by a combination of therapies including over the counter medications (like aspirin or Tylenol), fibromyalgia prescription drugs (muscle relaxants and antidepressants) and self-help techniques (see fibromyalgia treatment for an overview). Some days will be worse than others requiring stronger treatments. You may find the following article useful to read, what is the best treatment for fibromyalgia pain?
Most fibromyalgia patients are aware which factors trigger worsening symptoms in their own case. The most common causes include:
• Weather, usually cold and humidity.
Useful Questions and Answers Section
|Related Articles on Fibromyalgia
For more pain management, see the following:
Back To Homepage: Womens Health Advice