A Answers (7)
Mehmet Oz, MD, Cardiology, answeredThe 18 fibromyalgia tender points form a constellation around the neck, shoulder, chest, hips, knees and elbows. They are often in the same place as myofascial trigger points, firm nodules that often feel tight in your muscles. If you feel pain when light pressure is applied to pressure points on both the left and right side of your body (not just one side), and below and above the waist, such as around your knees as well as your neck and shoulders. Pain at 11 or more pressure points is a good indication of fibro, but you can have pain in fewer pressure points and still have fibro.Helpful? 6 people found this helpful.
Michael Roizen, MD, Internal Medicine, answeredThe American College of Rheumatology (ACR) has identified criteria for classification of fibromyalgia. This classification includes having pain in 11 of 18 tender points, or trigger points, on the body during an examination. The locations of the tender point sites are over the neck, shoulder blades, lower back, elbows, buttocks, knees, and other areas. The actual size of a trigger point is small, about the size of a dime. When your doctor checks for tender points, the doctor may check "control points" or nontender points on the body to make sure you don't react to these as well, or that might change the diagnosis. Some doctors use a special instrument called a doximeter or dolorimeter to apply just the right pressure on tender points during an exam.
Pfizer LYRICA™ (pregabalin) Team answeredThere are guidelines that can be very helpful in the diagnosis of fibromyalgia. In 1990, the American College of Rheumatology published the following criteria:
- Widespread pain above and below the waist, on both the right and left sides of your body, and in the axial skeleton (your skull, spine, rib cage, and the bones in your throat and ears) for at least 3 months
- Tenderness or pain in 11 of the 18 “tender points” on your body
Based on these guidelines, your doctor may perform a tender point exam. Your doctor will ask how long you have been having pain. Then he or she will apply pressure to these 18 points and count how many you find tender. Finding pain when pressure is applied to these tender points is how many doctors diagnose fibromyalgia.
These points are located in the following places on your body:
- Knees and hips
- Upper buttocks
- Upper chest
- Mid- to upper-back of the shoulders
- Front and back of the neck
*Individual results may vary.
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LYRICA is not for everyone. LYRICA may cause serious, even life threatening, allergic reactions. Stop taking LYRICA and call your doctor right away if you have any signs of a serious allergic reaction. Some signs are swelling of your face, mouth, lips, gums, tongue, throat or neck, or if you have any trouble breathing, or have a rash, hives or blisters.
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LYRICA may cause swelling of your hands, legs and feet, which can be serious for people with heart problems. LYRICA may cause dizziness and sleepiness. You should not drive or work with machines until you know how LYRICA affects you. Also, tell your doctor right away about muscle pain or problems along with feeling sick and feverish, or any changes in your eyesight including blurry vision, or if you have any kidney problems or get dialysis.
Some of the most common side effects of LYRICA are dizziness, blurry vision, weight gain, sleepiness, trouble concentrating, swelling of your hands and feet, dry mouth, and feeling “high.” If you have diabetes, tell your doctor about any skin sores.
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In studies, a specific type of blood vessel tumor was seen in mice, but not in rats. The meaning of these findings in humans is not known.
Do not stop taking LYRICA without talking to your doctor. If you stop suddenly you may have headaches, nausea, diarrhea, trouble sleeping, increased sweating, or you may feel anxious. If you have epilepsy, you may have seizures more often.
LYRICA is indicated to treat fibromyalgia, diabetic nerve pain, spinal cord injury nerve pain, and pain after shingles. LYRICA is also indicated to treat partial onset seizures in adults with epilepsy who take 1 or more drugs for seizures.
Piedmont Heart Institute answered
These trigger points are:
• front and back of neck
• mid to upper back of the shoulders
• upper chest
Celeste Cooper, Rheumatology, answered
Fibromyalgia tender points are specific areas of tenderness located on the “Tender Point Model.” The Model was used to screen people for research studies and was never meant to become the diagnostic tool for FM that it has become. According to the tender point criteria one must have tenderness at 11 of 18 predetermined sites when pressed. See http://www.thesethree.com/fibromyalgia/tender-points.php
The criticism with these criteria has been that some patients with FM and the comorbid conditions may not have 11 tender points or they have more than 18 in different areas of the body. Newer research suggests that tender points may actually me myofascial trigger points or tenderness in the pain referral pattern of a myofascial trigger point. See http://www.thesethree.com/cmp/myofascial-trigger-point.php
All blogs, posts and answers are based on the work in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN, and Jeff Miller, PhD. 2010, Vermont: Healing Arts press are for educational purposes and not meant to replace medical advice. www.TheseThree.com
Author of Chapter Five, Living with and Coping Effectively Through Fibromyalgia: Detecting Barriers, Understanding the Clues, in Fibromyalgia Insider Secrets: 10 Top Experts, 2nd Ed. Ebook complied by Deirdre Rawlings, ND, PhD
Find out more about this book:Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection
Jacob Teitelbaum, Integrative Medicine, answered
These tender points were arbitrarily chosen from dozens that are present for purposes of making the diagnosis and half are on the right and half are on the left side of the body. Fortunately, the new diagnostic criteria are eliminating the need for the tender point exam as most physicians are simply not trained in this. More importantly is the question "Do you hurt all over?", this is a more pertinent hallmark for fibromyalgia.
There are 18 soft tissue sites on the body called tender points that are highly sensitive to pressure in people with fibromyalgia, and much less tender in people who do not have fibromyalgia. Your doctor may use these points to diagnose this disease. They are clustered at the base of your skull and low cervical neck, on the trapezius muscles of your shoulders, and at the second ribs, lateral epicondyles, sacral area, hips, and knees.