What are tender spots?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Tender spots, also called "tender points," are specific places in the body that, when pressed, can hurt in people who have fibromyalgia, a common health problem that causes chronic, widespread muscle and joint pain and fatigue. Your doctor may palpate these tender spots during an examination if he or she suspects you have fibromyalgia. Other typical symptoms of fibromyalgia are trouble sleeping and memory problems or cloudy thinking, sometimes called the "fibro fog."  Fibromyalgia may also cause headaches, morning stiffness, numbness or tingling in your hands and feet and painful menstrual periods.
Tender spots, or tender points, are areas that have been identified in people with fibromyalgia, a condition characterized by pain and fatigue. They are specific areas on your body that feel tender or painful when pressure is applied.

Your doctor can use tender spots to help diagnose you with fibromyalgia. The American College of Rheumatology has identified 18 sites on the body that may be tender points if you have this condition. 
Dawn Marcus
People with fibromyalgia have areas called "tender points." There are 18 designated body regions that have been identified as being more likely to be tender to pressure in people with fibromyalgia.

In 1990, the American College of Rheumatology established a widely accepted system for diagnosing fibromyalgia. This system required people to have persistent widespread pain and a number of tender points -- seemingly unrelated areas on the body that are painful when pressed. Researchers have identified 18 areas that are typically tender when pressed in people who have fibromyalgia.

People with fibromyalgia often find the tender point examination a little silly, and may ask their doctors, “But doesn’t everyone find these spots tender when you press them?” The answer to this is a resounding “no!” At the University of Pittsburgh, we helped develop the tender point examination and studied these areas in people with fibromyalgia and other severe chronic pain conditions. We found that experiencing tenderness when these point areas were pressed was specific for fibromyalgia. Having many sensitive tender points occurs in fibromyalgia, but not in people with pain caused by other conditions. People with other conditions may have several painful tender points, but they usually don’t have as many, and they may also have other issues that help distinguish their symptoms from fibromyalgia. The most important message is that people with fibromyalgia have a different pattern of pain than do people with other chronic pain conditions.

Because doctors have difficulty performing the tender point exam and because the number of tender points fluctuates (so people may be diagnosed with fibro on Monday, but then not on Wednesday), the American College of Rheumatology changed the criteria to no longer require this exam.

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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.