What are fibromyalgia tender points?

Fibromyalgia tender points are the spots in the body that, with a certain amount of pressure, become painful and tender. These are also known as trigger points.

Healthcare professionals used to employ these tender points to diagnose fibromyalgia. There are 18 tender or trigger points located in areas like the knees, hips, the back of the head, and the outside of the elbows. To receive a diagnosis of fibromyalgia, someone would have to experience pain and tenderness in 11 of these points.

But, tender points are no longer used as the sole diagnostic criteria for fibromyalgia. As research on the condition has advanced, experts have learned that there are other key factors to take into account when diagnosing fibromyalgia, which is already a hard-to-diagnose condition. 

Learning more about these tender points, how they’re used in diagnosis now, and the treatment options can help you understand and manage the condition more effectively.

What is fibromyalgia? 

Fibromyalgia is a chronic condition that causes pain throughout your body, fatigue, and difficulty sleeping. About 4 million adults in the United States have it, and fibromyalgia affects 2–4% of the population in the world. 

Other symptoms include:

• muscle and joint stiffness
• headaches and migraine
• difficulty focusing and concentrating 
• constipation
• numbness and tingling in hands and feet

Although anyone can develop the condition, there are some risk factors that increase the possibility of having the condition, including:

• being female
• having certain conditions like rheumatoid arthritis, lupus, osteoarthritis, or irritable bowel syndrome

The likelihood of developing fibromyalgia increases as you get older, although children and young adults can also develop it. 

The causes of fibromyalgia are not fully known, but experts think that genetics as well as environmental factors play a role in the development of the condition.

There’s no cure for fibromyalgia, but you can cope with the symptoms and improve your quality of life by following certain strategies, such as a balanced diet that excludes trigger foods, exercising, and medical and alternative treatments. 

What and where are fibromyalgia tender points? 

Tender or trigger points are areas in your body that, when pressure is applied, can feel painful and tender. Doctors and healthcare professionals used to employ these trigger points to diagnose fibromyalgia. 

There are 18 tender points, which are symmetrical and grouped into nine pairs. These pairs are located at:

• the back of the neck
• the halfway point between the base of the neck and the tip of the shoulder
• the point where the back muscles connect with the shoulder blade
• the front of the neck.
• the right and the left of the sternum
• forearm in the area below and outside the elbow’s crease
• above and to the outside of the buttock
• outer upper leg near the hip
• inside of each knee

But doctors have stopped using tender points as diagnostic criteria for fibromyalgia. Some old research from 2003 suggests that the use of tender points led to the overdiagnosis of fibromyalgia or the misdiagnosis of the condition in people that didn’t meet the 11-point criteria and experienced other symptoms.

Diagnosis

The diagnosis of fibromyalgia no longer relies on tender points. In fact, the American College of Rheumatology, which in the 1990s included tender points in the diagnostic criteria of fibromyalgia, changed guidelines in 2010 to no longer require counting trigger points in the diagnosis of the condition.

Nowadays, there’s still no specific imaging or lab test to help diagnose fibromyalgia. To diagnose fibromyalgia, doctors look at your medical history and do a physical exam.

From these, doctors will rule out other conditions that cause the symptoms of chronic pain, fatigue, and trouble sleeping. Your doctor may also order other tests to help rule out other conditions, such as lupus and rheumatoid arthritis.

Treatments and pain management

The treatment and management of fibromyalgia and its symptoms include medical interventions, lifestyle strategies, and natural remedies. These include:

• Medications: pain relievers, such as ibuprofen (Advil), antidepressants like duloxetine (Cymbalta), and anticonvulsants, namely pregabalin (Lyrica).
• Lifestyle strategies: a balanced diet, exercise such as yoga, walking, and meditation
• Talk therapy: cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)
• Alternative therapies: acupuncture, biofeedback, massage

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Summary

Fibromyalgia tender points are areas of the body that, when a certain amount of pressure is applied, trigger pain and tenderness. There are 18 tender points in the body, and these used to be employed to diagnose the condition.

But doctors have stopped using tender points to diagnose fibromyalgia because not everybody meets the criteria of counting tender points, and people with the condition can show other symptoms. Research suggested that using tender points led to the overdiagnosis and the misdiagnosis of fibromyalgia.

Nowadays, there’s no specific lab or imaging test to help diagnose the conditions. Doctors will ask about your medical history and the severity and duration of your pain, and they will perform a physical exam. They may also order other tests to rule out conditions that have similar symptoms.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.