Understanding Fibromyalgia Tender Points
Years ago, I taught a class on the “power of touch.” There was a case study on the healing effect of human contact and touch.
Those who received hugs, light massage and affection experienced a greater reduction of pain as well as a shorter recovery period than those who did not. The physicians conducting the research took the study even further by visiting a burn unit.
While the patients could not tolerate touch, the therapists would simply wave their hands slowly over the body just inches from the patient. It seems that the patient could still “feel” the healing effect of closeness and experienced reduction in pain as well as faster recovery.
As a person who is quite affectionate by nature, I have experienced the healing effects of touch. Sometimes a hug or a soft embrace can melt away stress and pain as no medication can.
When I first began to show symptoms of fibromyalgia though, it was heartbreaking to me to not be able to tolerate touch like I once had. I was a hugger, and it wasn’t fair!
There were days when I even felt as if my hair hurt. I couldn’t stand to blow dry or brush my hair. Hugs or handshakes were like torture on those flare-up days. At night when I laid down, it hurt for my knees or ankles to touch each other, or my hands and arms to touch the mattress.
Of the multiple symptoms and conditions that fibromyalgia brings, the pain of fibromyalgia tender points and trigger points is one of the most difficult to get used to.
What Are Fibromyalgia Tender Points?
Fibromyalgia tender points are areas of pain around joints, but not in the joints themselves. Joint pain would be an indicator of arthritis, but tender points are a sign of fibromyalgia.
These places hurt when you press on them. They are often not deep areas of pain.
Instead, they seem to be just under the surface of the skin. It has been speculated that fibromyalgia is due to sensitivity in the nerves of the body which would explain the surface pain of these tender points.
The place that’s the most tender is usually tiny, about the size of a penny. These spots are much more sensitive than other nearby areas. In fact, pressure on one of the tender points with a finger will cause pain that makes the person flinch or pull back.
Doctors don’t know for certain what causes these pressure points, but they do know that their locations are not random. They happen in predictable places on the body. That means many people with fibromyalgia have similar symptoms with their tender points.
Routine lab tests do not detect the widespread pain of fibromyalgia. Instead, a doctor diagnosis by a physical exam of these pressure points.
Light pressure is applied to the surface of the muscles throughout the body in eighteen (9 pairs) specific tender points or pressure points. Patients with fibromyalgia find this painful, particularly in these specific tender point areas used for diagnosis.
To be diagnosed with fibromyalgia, the patient must experience pain in at least 11 of the eighteen tender points.
Where Are Fibromyalgia Tender Points Located?
If you suffer from fibromyalgia, you might ask, “Where doesn’t it hurt?” on many days.
Still, the specific tender points common to everyone diagnosed with fibromyalgia are scattered over the neck, back, chest, elbows, hips, buttocks, and knees.
- Back of the neck. If you have fibromyalgia, you may have tender points at the back of the neck, where the base of the skull and the neck meet.
- Elbows. Fibromyalgia patients may also feel tenderness on their forearms, near the crease of each elbow. The pain tends to be below the crease and toward the outer side of the arm.
- Front of the neck. In addition to the back of the neck, doctors will check potential fibromyalgia patients for pain at the front of the neck. This pair of trigger points is located well above the collarbone, on either side of the larynx.
- Hips. Hip pain is common in those with osteoarthritis, but people with arthritis tend to feel it in the joint. In contrast, people with fibromyalgia may have a tender point near where the buttock muscles curve to join the thighs.
- Lower back. The lower back is one of the most common body parts to be the source of pain. Overall, more than 1 in 4 U.S. adults has experienced low back pain.However, people with fibromyalgia may have pain trigger points at the very top of the buttocks, right at the bottom of the lower back.
- Knees. While knee trouble is common in people with fibromyalgia, the inside of each knee pad may feel tender to the touch.
- Upper back. Tender points are often sites on the body where tendons and muscles meet. Such is the case for this pair of tender points, located where the back muscles connect to the shoulder blades in the upper back.
- Shoulders. In addition to tenderness in the upper back, some people with fibromyalgia have tender points just above that, halfway between the edge of the shoulder and the bottom of the neck.
- Chest. People with fibromyalgia may have tender points on either side of the sternum, a few inches below the collarbone (near the second rib). The sternum, also known as the breastbone, helps protect the heart and lungs.
Next page: What can make fibromyalgia tender points worse? What is the difference between fibromyalgia tender points vs. trigger points? Treatment options and more.