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 ...
Fibromyalgia (FM) must be diagnosed by a qualified physician who is familiar with the illness and has experience diagnosing it. The specialists who most often diagnose and treat fibromyalgia are rheumatologists. In 1990, the American College of Rheumatology established the diagnostic criteria for fibromyalgia . Both of the following must be present: A history of widespread pain in all four quadrants of the body for a minimum duration of three months, and Pain in at least 11 of 18 designated tender points when four kilograms (about 10 pounds) of pressure are applied. (See a diagram of the fibromyalgia tender points here .) Although the American College of Rheumatology does not classify fibromyalgia as a diagnosis of exclusion, there are several other illnesses that have similar symptoms and sometimes occur along with FM. Therefore, it is important that the doctor test for certain comorbid conditions as well. Which tests may be necessary wi...
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...
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