Question

Fibromyalgia

What are the 18 tender points used to diagnose fibromyalgia?

A Answers (3)

  • AMichael Roizen, MD, Internal Medicine, answered
    The 18 tender points or trigger points used to diagnose fibromyalgia are scattered all over the body. Tender points are found on the neck, shoulder blades, lower back, elbows, buttocks, knees, and other areas. These tender points are quite small, but a good doctor knows how to locate them. During the examination, the doctor will use control points to test to make sure you do not react to the nontender points. If you do, the diagnosis may not be fibromyalgia. To meet the diagnostic criteria for fibromyalgia, you must have pain in 11 of the 18 tender points. 
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  • In order to be diagnosed with fibromyalgia, you must experience discomfort in at least 11 of 18 tender points designated by the American College of Rheumatology. There are 8 tender points on the front of the body and 10 on the back. They occur symmetrically down the body. On the front of the body they are located at the bottom of the neck just above the collarbone, just below the center of each collarbone, on the crease inside each elbow, and lastly on the inside of each knee. On the back of the body they are located at the bottom of the neck, above each shoulder blade, just inside each shoulder blade, at the top of the butt on either side of the lower spine, and lastly just underneath the butt on the outer part of each hamstring.

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  • AMehmet Oz, MD, Cardiology (Cardiovascular Disease), answered
    The 18 tender points were developed by the American Academy of Rheumatology (AAR) to help identify people with fibromyalgia. These are 18 spots on the body, including the back of your head, elbows, shoulders, knees, hip joints and around your neck, that may be super sensitive if you have fibro. If you have fibromyalgia, when your doctor applies light pressure to these spots with his or her finger (just enough for the nail bed to become white), you may feel pain. But people without fibro normally wouldn't even flinch. If you have pain when your doctor touches 11 of the 18 tender points, that supports a diagnosis of fibromyalgia. You need to feel pain on both sides of the body, and above and below the waist. But even If you feel pain in fewer than 11 tender points, you may still have fibromyalgia. Some doctors use a more informal diagnostic system that the AAR has developed, so work with your doctor if you think you may have fibromyalgia. The second diagnostic system is based on self-reported severity of symptoms.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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