The Difference Between Tender Points and Trigger Points
Achieving a fibromyalgia diagnosis undoubtedly takes years – in fact, the National Fibromyalgia and Chronic Pain Association estimates that most people wait an average of five years to reach their diagnosis.
What makes achieving a diagnosis of fibromyalgia complicated?
It's the inexperience of health care providers and the ambiguity of diagnostic guidelines.
Diagnostic Guidelines of Fibromyalgia
According to Mayo Clinic, fibromyalgia is “characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points. In the past, at least 11 of these 18 spots had to test positive for tenderness to diagnose fibromyalgia.”
The problem with the prior diagnostic criteria is that the tender points come and go, so on the day you go to visit your physician you may only have several tender points when the day before you had 13 tender points.
Because fibromyalgia pain is constantly changing, a new physician may not how much pressure to exert during an exam to provoke a response.
Today, fibromyalgia has new diagnostic guidelines:
- Feeling of widespread pain that lasts at least three months.
- Other symptoms that are present, such as fatigue, trouble thinking, and waking up tired.
- Ruling out other conditions.
Keep in mind that there is no lab test or imaging study that can diagnose fibromyalgia – it is, unfortunately, diagnosed purely on symptoms.
Fibromyalgia is often diagnosed in conjunction with other conditions including anxiety, frequent and painful urination, headaches, jaw pain, irritable bowel syndrome, chronic pain and depression.
What is a Tender Point?
Fibromyalgia is diagnosed based on the presence of pain at various tender points.
A tender point is a pain point or localized areas of tenderness around joints, but not the joints themselves. These tender points hurt when pressed with a finger. Tender points are typically not deep pain, but rather the pain is felt near the surface of the skin.
The tender points are also small – about the size of a penny. In addition to pain, they are more sensitive than the surrounding areas.
It is unknown what causes tender points. There does not seem to be inflammation at the spots. However, there is a trend – people with fibromyalgia have tender spots in the same predictable locations.
There are 18 tender points scattered throughout the body including the neck, chest, hips, and knees.
What are Trigger Points?
You may have also heard of trigger points – although tender points explain a lot of your fibromyalgia pain, it may not explain all of it.
While tender points can pinpoint quite a few areas of pain you may be experiencing, trigger points are the result of chronic myofascial pain. These points may cause the “deeper” muscular pain that you feel. Also, tender points often are symmetrical while trigger points are not.
Trigger point pain may be experienced at:
- Front lower sides of the neck
- Upper chest
- Inner elbows
- Upper buttocks
- Shoulder blades
- Tops of shoulders
- Back of the head
- Just above inner knees
What Causes Fibromyalgia?
With such widespread pain, what causes fibromyalgia?
Unfortunately, at this time no cause can be pinpointed. However, there does seem to be some risk factors for developing fibromyalgia.
It is estimated that 90% of the people who get fibromyalgia are adult women and currently, there are 5 million Americans over the age of 18 living with this disease.
Additionally, there are theories that people who have undergone traumas such as an automobile accident, repetitive injuries, or those living with severe illnesses may also increase the risk of developing fibromyalgia.
Some researchers believe that it is simply an issue with how the central nervous system works, is another cause for fibromyalgia.
According to National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), there is research that indicates, “people with fibromyalgia may have a gene or genes that cause them to react strongly to stimuli that most people would not perceive as painful. There have already been several genes identified that occur more commonly in fibromyalgia patients, and NIAMS-supported researchers are currently looking at other possibilities.”
Learn more about the tender points of fibromyalgia on NewLifeOutlook.