This is fibromyalgia (FM) awareness month, so it is only fitting that we clear up some confusion between tender points and trigger points. Knowing the difference can affect your diagnosis and treatment.
What are Tender Points?
Tender points are specific areas of tenderness, which have been mapped out on the “Tender Point Model.” The tender point model became part of the American College of Rheumatology criteria in 1990 after its development for a fibromyalgia study.
Characteristics of Tender Points
The examiner cannot feel them.
They cause local pain when pressed.
They are no longer restricted to points on the tender point model.
Though often found around joints.
They are not related to joint disease or joint pain.
They do not cause deep pain.
They are not related to muscle pain.
Tenderness is due to an upset in the central nervous system, called centralization.
Finding Pause for the Use of the Tender Point Model
Those who treat ...
For years people with fibromyalgia who are unable to continue working at a full-time job have struggled and worried about whether they would qualify for Social Security Disability. Finally, last week the Social Security Administration issued a ruling providing guidance on how they develop evidence to establish that a person has a medically determinable impairment (MDI) of fibromyalgia, and how they evaluate fibromyalgia in disability claims and continuing disability reviews under titles II and XVI of the Social Security Act. This ruling went into effect on July 25, 2012.
For a complete copy of the ruling, including footnotes, references and a tender point diagram, see Social Security Ruling, SSR 12-2p; Titles II and XVI: Evaluation of Fibromyalgia in the Federal Register. Following is a copy of the core elements of the ruling that I think would be of most interest to people with fibromyalgia.
Fibromyalgia is a complex medical condition characterized p...
Diagnosis There is no obvious, objective method (such as laboratory or imaging tests) for diagnosing fibromyalgia. The criteria used to study fibromyalgia are very helpful, particularly if the patient does not have another disorder, such as depression or arthritis, which could complicate the diagnosis. Failure to meet the criteria, however, does not rule out fibromyalgia. Fibromyalgia should be suspected in any person who has muscle and joint pain with no identifiable cause. Because many patients do not meet the current fibromyalgia criteria, the American College of Rheumatology (ACR) has proposed a new set of diagnostic criteria that take into consideration symptoms such as fatigue, sleep disturbance, and cognitive problems, in addition to pain. Criteria for Classifying Fibromyalgia In 1990, the ACR set the following criteria for classifying fibromyalgia: A. Widespread pain must be present for at least 3 months. This pain must appear in all of the following locations: Both sides of the bod...
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