In spinal healthcare, two primary types of points are used to delineate different types of pain and their relevant causes: Tender points and trigger points. While it’s easy to confuse these two different methods of pinpointing pain, it’s important to realize they refer to distinct and separate phenomena.
Tender points relate to fibromyalgia. They’re a useful diagnostic tool chiropractors and other holistic healthcare providers can use to provide an accurate diagnosis of fibromyalgia versus other types of chronic pain. If you have 11 or more of the 18 established tender points, it’s likely your chiropractor will diagnose you with fibromyalgia. However, you may still receive a diagnosis even if you have less than 11.
Trigger points, meanwhile, are areas of concentrated, tightly wound muscle fibers. Trigger points are associated with localized and referred pain. Also called muscular knots, trigger points are often associated with underlying musculoskeletal conditions that could cause long-term adverse health problems if left untreated.
Doctors have determined 18 different Fibromyalgia trigger points in the body based on cases of fibromyalgia around the world. Many may describe their symptoms of pain as “I hurt all over”.
In the process of trying to determine what is painful and why a person is feeling sensations of pain, medical doctors have broken down common areas of the body into what is now known as trigger points.
For someone experiencing this condition, pressing these different trigger points will be incredibly painful. A normal person will likely describe the pressing sensation as pressure and not as pain.
The trigger points which will be assessed during a consultation with a doctor are:
Fibromyalgia Trigger Points Illustration
Back of the neck: Pain may be felt in the area where the skull meets the neck. Common influencers which may be triggering or causing the pain could be injury, activities which strain the neck or rheumatoid arthritis.
Front of the neck: Pain can also occur at the front of the neck, just above the collarbone and on either side of the larynx.
Upper back: Pain is particularly tender in the area where back muscles connect to the shoulder blades in the body.
Lower back: Pain is commonly felt at the top of the buttock area, at the base of the back.
Shoulders: Some experience pain in the area of the upper back that is halfway between the edge of the shoulders and the base of the neck.
Chest: Pain may also be felt on either side of the sternum, just beneath the collarbone in the chest area.
Hips: Where the buttock muscles curve and join the thighs of the body, pain can occur. Some triggers may be similar to those of osteoarthritis.
Elbows: Pain and stiffness can also be felt in the forearms, near the crease of the elbow and out towards the outer side of each arm. Some triggers could be repetitive strain injuries to the same area or tendonitis.
Knees: A person with fibromyalgia will experience pain, tenderness or stiffness on the inside of each knee pad.
Doctors don’t know what causes these pressure points. But they do know that their locations are not random. They happen in predictable places on the body. That means many people with fibromyalgia have similar symptoms with their tender points. Your doctor can test the painful tender points during a physical exam. But you also need to tell them about the exact pain you feel in those areas. Tell them about your other symptoms of fibromyalgia, too, such as deep muscle pain, fatigue, and sleep problems. If you've been diagnosed with irritable bowel syndrome, let the doctor know. IBS sometimes coincides with fibromyalgia.
When a doctor tests tender points for pain, they will also check other non-tender places on your body called control points to make sure you don't react to these as well. To get an official diagnosis of fibromyalgia, you must feel widespread pain for at least 3 months.
Treatment
Your treatment plan will depend on the nature of your doctor’s findings. If another condition is determined as the underlying cause of your symptoms, an appropriate course of treatment will apply. If fibromyalgia is diagnosed, a doctor will likely prescribe medications and make specific self-care recommendations. The disorder is chronic in nature, meaning you will need to make adjustments to your lifestyle.
Your doctor will stress that any recommendations they make will be to help minimise the effects of your symptoms and assist you with being able to improve your overall health condition and quality of life. No single treatment plan currently helps alleviate all symptoms. Medications will be recommended to help reduce symptoms of pain, and by extension also help to improve your ability to sleep comfortably.
