Fibromyalgia (fi-bro-my-AL-ja) syndrome (FMS) produces chronic body-wide pain, which migrates and can be felt from head to toe.

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Fibromyalgia Pressure Point

The American College of Rheumatology bases the diagnosis of FM upon two major criteria: 1) widespread, diffuse pain lasting at least three months and 2) a minimum of 11 (out of 18 possible) specified tender points throughout the body. This is the strict definition for being included in a clinical study of fibromyalgia, but tender points may change from time to time, and may worsen or get better in the cyclical way that this syndrome seems to work.

These tender points will hurt when pressed, but the pressure will not cause pain in any other part of the body. The physician applies a standardized amount of pressure, about 4 kg (enough to turn the thumbnail white). Remember, a tender point has to be painful at palpation, not just "tender." When pressed, these areas tend to feel like bruises in various stages of healing.

Also, a tender point is different from what you may know as a trigger point. Tender points hurt, trigger points hurt and refer pain to other body parts. Trigger points cause myofascial pain syndrome, which often coexists with fibromyalgia, but can be treated with massage, physical therapy, or gentle stretching. When muscles feel hard and pressing on them causes a response elsewhere in the body, or even nausea, trigger points are responsible. Tender points are caused by an unknown mechanism, and their severity is often cyclic. Tender points do not generally respond to physical therapy, often becoming more painful with pressure.

Widespread pain is defined as having pain in both sides of the body and pain above and below the waist. In addition, pain must also be present in the cervical spine, anterior chest, thoracic spine or lower back.

These tender points are located at:

  • Occiput (2) - at the suboccipital muscle insertions (near the base of the skull)
  • Low cervical (2) - at the anterior aspects of the intertransverse spaces at C5-C7 (the lower vertebra of the neck)
  • Trapezius (2) - at the midpoint of the upper border (the neck, mid back and upper back muscles between the shoulder blades)
  • Supraspinatus (2) - at origins, above the scapula spine near the medial border
  • Second rib (2) - upper lateral to the second costochondral junction (the insertion of the second rib)
  • Lateral epicondyle (2) - 2 cm distal to the epicondyles (the side of the elbow)
  • Gluteal (2) - in upper outer quadrants of buttocks in anterior fold of muscle (the upper and outer muscles of the buttocks)
  • Greater trochanter (2) - posterior to the trochanteric prominence (the upper part of the thigh)
  • Knee (2) - at the medial fat pad proximal to the joint line (the middle of the knee joint)


Fibromyalgia Resources:   Fibromyalgia Pressure Point by nfra.net
  Fibromyalgia Specialist by fibromyalgia-syndrome.com
  Fibromyalgia Nutrition by fibromyalgia-treatment.org

Resourse Sites:

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Resource Sites:

www.nfra.net | www.fibromyalgia-syndrome.com | www.fibromyalgia-treatment.org

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National Fibromyalgia Research Association
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