Fibromyalgia is diagnosed when patients experience pain in 11 out of 18 fibromyalgia tender points in specific locations throughout the body. The pain experienced by patients when these points are stimulated is generally consistent for fibromyalgia patients, leading doctors to come to a diagnostic method of detecting fibromyalgia. These tender points are exclusive to fibromyalgia.
When pressure is applied to these areas, patients experience intensified pain much stronger than normal individuals. The pain experienced by patients varies, but many have described it as needles, burning, or a deep throbbing pain.
The Manual Tenderpoint Survey (MTPS) has become a standard method of diagnosing fibromyalgia since 1990. Signs and symptoms of fibromyalgia have been present in patients since ancient history. Diagnostic criteria was only established after a study conducted on 558 patients by the American College of Rheumotology ,in which the majority of patients suffered from widespread pain as well as pain in specific areas of the body, known today as fibromyalgia tenderpoints.
- Low Cervical Region (front neck area)
- Second Rib (front chest area)
- Occiput: (back of the neck)
- Trapezius Muscle (back shoulder area)
- Supraspinatus Muscle (shoulder blade area)
- Lateral Epicondyle (elbow area)
- Gluteal (rear end)
- Greater Trochanter: (rear hip)
- Knee (knee area)
Fibromyalgia Tender Points Diagram
Currently, the diagnosis for fibromyalgia is heavily reliant on these specified tender points. Other criteria used for diagnosis is generalized pain for at least 3 months as well as an exclusion of other diseases such as arthritis and lyme disease. Other minor criteria is based on other symptoms that usually accompany patients such as depression, anxiety, insomnia and irritable bowel syndrome. Survey evaluation is also a method used by some doctors as they believe a patient may better describe their symptoms.
Studies have shown that pain in these areas varies from day to day, causing some scientists to question the diagnostic validity of using 11 points as a method of diagnosing a condition . There are no standardized guidelines for intensity and duration of pressure. On the other hand, this may be due to the inconsistency of the condition. While some days patients may feel that they have pain all over, other days their tender points may feel less susceptible to sensitivity.
These tenderpoints are very often confused with myofascial trigger points which are caused by myofascial pain, a seperate condition from fibromyalgia . Unlike fibromyalgia tender points, myofascial trigger points can be detected by touch and can spring up anywhere on the body. These trigger points are easily treatable through various methods. Fibromyalgia tenderpoints are part of a bigger cause.