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Fibromyalgia Tender Points: Where Does It Hurt?

May 15, 2017 in Fibromyalgia

Patients suffering from fibromyalgia, or FMS, find their entire lives disrupted, and can have a hard time performing even the most basic tasks. The good news is that there are effective treatments available that can manage the pain and allow patients to live a productive life. Learn about the most common fibromyalgia tender points, where FMS sufferers experience pain, and the different types of therapy to help, from cold therapy to TENS.

What are Fibromyalgia Tender Points?

Tender points are localized areas of pain and tenderness that surround the joints, as opposed to the joints themselves. These points are not deep aches — they are physical pain that is sensitive to touch. That is, when you press a tender point, it hurts. They tend to feel like they’re right under the surface of the skin and can be around the shoulder, elbow or other areas.

These tender points are not large areas; rather, they’re approximately the size of a penny — just a few centimetres across — and tend to be far more sensitive than other areas nearby. They can be scattered across a variety of areas of the body.

What are the first signs of fibromyalgia?

Trigger Points vs. Tender Points

Many patients confuse tender points with trigger points. Trigger points are areas that are connected with myofascial pain, and tender points are areas that cause pain in other areas of the body. Since fibromyalgia is often accompanied by chronic myofascial pain, it can be easy to confuse the two, but they are distinct. You may, for example, experience shoulder pain from an FMS tender point as well as from a myofascial trigger point.

One important way to differentiate the two is to understand that FMS tender points occur on both sides of the body symmetrically. That is, if you experience a tender point above your elbow on the right side, you should also experience it on the left elbow in the same place.

What Are Common Fibromyalgia Tender Points?

These common fibromyalgia tender points are one of the primary methods for diagnosing FMS in patients with chronic pain. There are eighteen points in total, breaking down to nine symmetrical pairs. According to the American College of Rheumatology, those suffering from FMS usually suffer pain from at least 11 of these tender points.

Tender point pairs include:

  1.      Sides of the neck (front, lower)
  2.      Each side of the upper chest
  3.      The inner elbows
  4.      The inside of the knees
  5.      The back of the head on the sides
  6.      The tops of the shoulders
  7.      Shoulder blades
  8.      Upper buttocks
  9.      Above the hips

Medication for Fibromyalgia

Fortunately, as medicine continues to advance, there are new and better treatments for managing FMS pain coming to light every single day. These treatments can go a long way towards managing the physical discomfort and psychological strain that goes along with this chronic illness.

One of the most common treatments is the use of medication. Pain relievers — especially muscle relaxants and over-the-counter anti-inflammatories like ibuprofen or naproxen sodium — can help to reduce the inflammation and pain you suffer, as well as enabling you to sleep better at night. In more severe cases, doctors may prescribe antidepressants to reduce fatigue and pain, or anticonvulsants to help to relax the joints and muscles.

Before starting any sort of medication, it’s vital you talk with your doctor to discuss potential side effects.

Non-Invasive Fibromyalgia Treatments

There are a number of treatments for FMS that don’t involve medications or invasive procedures. These range from yoga, which can help to stretch and relax muscles, to various physical therapy routines such as cold therapy and massage therapy.

One particularly strong method of treating FMS pain is TENS therapy. TENS stands for transcutaneous electrical nerve stimulation and is a safe, non-invasive and effective means of treating both regional and localized pain like that from fibromyalgia trigger points. TENS devices deliver electrical impulses through the skin and stimulate nerve pathways to relieve many kinds of pain. With modern technology, you can even perform this therapy at home.


Get More Information

For a quick overview of fibromyalgia and its treatments, view Dr-HO's Fibromyalgia page.

If you’d like more information about how TENS pain therapy can be used to treat fibromyalgia at home, check out our website and get in touch with us about how we can help. Read the article Fibromyalgia: This is Everything You Need to Know for more information on this condition. 

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Fibromyalgia Symptoms: How Do I Know If I Have Fibromyalgia?

Fibromyalgia Diet: What to Eat & What to Avoid as a Fibromyalgia Sufferer

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Fibromyalgia Tender Points: Where Does It Hurt?

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The Fibromyalgia Management Plan: Meal Plan, Exercise Routine, and More!


  1. WebMD. “Fibromyalgia Tender Points.” http://www.webmd.com/fibromyalgia/guide/fibromyalgia-tender-points-trigger-points#1
  2. Spine Universe. “Fibromyalgia Tender Points: Why They’re Not the Same as Trigger Points.” https://www.spineuniverse.com/conditions/fibromyalgia/fibromyalgia-tender-points
  3. Health.com. “18 Points Used to Diagnose Fibromyalgia.” https://www.spineuniverse.com/conditions/fibromyalgia/fibromyalgia-tender-points
  4. Fibromyalgia Symptoms. “TENS Therapy for Fibromyalgia Treatment.” http://www.fibromyalgia-symptoms.org/tens-therapy.html
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