Introduction
Fibromyalgia is a chronic pain disorder that causes widespread musculoskeletal pain, fatigue, and cognitive issues. One of the key features of fibromyalgia is tender pressure points, also known as tender points, which are specific areas of the body that become extremely sensitive to touch.
These pressure points are not random—they are located in specific, symmetrical areas of the body. While pressure points were once used for diagnosing fibromyalgia, doctors now consider a broader range of symptoms in diagnosis.
In this article, we will explore the 18 fibromyalgia pressure points, why they hurt, and how to manage pain effectively.
What Are Pressure Points in Fibromyalgia?
Difference Between Pressure Points and Trigger Points
- Pressure Points (Tender Points) → Specific pain-sensitive areas that cause localized pain when pressed.
- Trigger Points → Areas of muscle tightness or knots that can cause referred pain (pain that radiates to other parts of the body).
Fibromyalgia is primarily associated with tender pressure points, while trigger points are more common in myofascial pain syndrome.
How Tender Points Are Used for Diagnosis
Previously, doctors used a tender point test where they applied light pressure to 18 designated spots. If a patient experienced pain in at least 11 out of the 18 points, they were diagnosed with fibromyalgia.
However, because fibromyalgia symptoms are more complex, tender points are no longer the only diagnostic tool.
Where Are the 18 Tender Points Located?
The 18 tender points are found in nine symmetrical pairs across the upper and lower body.
Upper Body Tender Points
Back of the head – At the base of the skull.
Front of the neck – On the sides of the throat, just above the collarbone.
Top of the shoulders – Where the neck meets the shoulder blade.
Upper chest – Just below the collarbone.
Inner elbows – On the inside of the arms, near the crease of the elbow.
Lower Body Tender Points
Upper back – Between the shoulder blades.
Lower back – Just above the buttocks, near the hip bones.
Hips – On the outer sides, near where the legs attach to the torso.
Knees – On the inner side, just below the knee joint.
Common Symptoms Associated with Tender Points
People with fibromyalgia experience pain in these areas when touched. Other symptoms include:
Burning or aching sensation in the affected spots.
Increased pain sensitivity (even light pressure can cause discomfort).
Muscle stiffness and tenderness around the joints.
How Are Pressure Points Diagnosed?
The Role of the Tender Point Test
During the tender point test, doctors apply light pressure (about 4 kg of force) to each of the 18 tender points to check for pain response.
Why Tender Points Are No Longer the Sole Diagnostic Method
Doctors now consider other fibromyalgia symptoms, such as:
✔ Chronic fatigue
✔ Sleep disturbances
✔ Cognitive issues (fibro fog)
✔ Digestive problems (IBS)
This more comprehensive approach ensures an accurate diagnosis.
Why Do Fibromyalgia Pressure Points Hurt?
The Role of Central Sensitization
People with fibromyalgia have central sensitization, meaning their nervous system overreacts to pain signals.
How the Nervous System Amplifies Pain
- Hyperactive nerve responses make normal pressure feel like intense pain.
- Inflammation and neurotransmitter imbalances worsen discomfort.
- Emotional stress can increase nerve sensitivity, making pain feel worse.
Because fibromyalgia pain is neurological, it requires specialized treatment beyond typical muscle pain remedies.
Effective Ways to Manage Fibromyalgia Pressure Points
1. Medication and Medical Treatments
✔ Pain relievers – Over-the-counter (OTC) painkillers like ibuprofen (Advil) or acetaminophen (Tylenol) may provide temporary relief.
✔ Antidepressants (Duloxetine, Amitriptyline) – Help regulate pain signals in the brain.
✔ Anticonvulsants (Pregabalin, Gabapentin) – Reduce nerve sensitivity and improve sleep.
2. Physical Therapy and Stretching Exercises
- Gentle stretching can relieve muscle tightness around pressure points.
- Physical therapy helps improve mobility and reduce pain flare-ups.
- Low-impact exercises like yoga and tai chi can ease muscle tension.
3. Heat Therapy and Massage for Tender Points
✔ Warm baths, heating pads, or infrared therapy can soothe aching muscles.
✔ Gentle massage therapy can release tension, but deep tissue massage may worsen pain.
4. Acupuncture and Alternative Therapies
✔ Acupuncture – Helps stimulate pressure points to improve circulation and reduce pain.
✔ Chiropractic adjustments – Some fibromyalgia patients find relief through spinal alignment techniques.
Frequently Asked Questions (FAQs)
1. Do Fibromyalgia Pressure Points Move?
No, the 18 tender points remain in the same locations, but pain levels can fluctuate depending on stress, sleep, and activity.
2. Are Tender Points the Same as Trigger Points?
No, tender points cause localized pain, while trigger points create radiating pain in surrounding areas.
3. Can You Reduce Pain in Pressure Points Naturally?
Yes! Exercise, relaxation techniques, proper sleep, and dietary changes can help reduce pain sensitivity.
4. What Causes Fibromyalgia Pressure Points to Flare?
Stress and anxiety
Overexertion or lack of movement
Cold weather or weather changes
Poor sleep and fatigue
5. How Is Fibromyalgia Diagnosed Today?
Doctors now use the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) to evaluate overall fibromyalgia symptoms rather than just relying on tender points.
Conclusion
Fibromyalgia pressure points are specific, sensitive areas that cause localized pain when pressed. While they were once the primary method for diagnosing fibromyalgia, doctors now consider a range of symptoms to ensure accurate diagnosis and treatment.
By using medication, physical therapy, relaxation techniques, and alternative treatments, you can reduce pressure point pain and improve your quality of life.
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