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TENDER POINTS

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  • Occiput (2)  [back of the head]: at the suboccipital muscle insertions;

  • Low cervical (2): at the anterior aspects of the intertransverse spaces (the spaces between the transverse processes) at C5 – C7;

  • Trapezius (2) [either of a pair of large triangular muscles extending over the back of the neck and shoulders]: at the midpoint of the upper border;

  • Supraspinatus (2) [shoulder blade area]: at origins, above the scapular spine near its medial border;

  • Second rib (2): just lateral to the second costochondral junctions, on the upper rib surfaces;

  • Lateral epicondyle (2) [elbow area]: 2 cm distal to the epicondyles (in the brachioradialis muscle);

  • Gluteal (2) : in upper outer quadrants of buttocks in the anterior fold of muscle;

  • Greater Trochanter (2) [rear hip]: posterior to the trochanteric prominence;

  • Knee (2): at medial fat pad proximal to the joint line.

 

TENDER POINT EXAMINATION BY DOCTOR

During the tender point examination, the person must have pain on palpation of designated tender point sites to meet the diagnosis of FM.   


The specific tender points on the body  touched with a force that is not painful to healthy people, produces pain in those with FM.

FM IN YOUNG PEOPLE

The severity and symptoms in young people may be similar but tend to differ from day to day or hour to hour than in adults. Pain, fatigue, and cognitive problems are difficulties facing them and are hardships they have to cope with, especially if attending school.

[Please see our Resources for our TEACH-ME Resource Book, information for teachers and parents]

FM CAUSES

 

There appears to be a genetic factor involved in some patients.  A physical trauma, such as a whiplash or spinal injury, can trigger FM in some patients.  In other cases it comes on gradually with no known cause.

 

DESCRIPTION OF PAIN

The pain has been described stiffness, burning, radiating, and aching. Most people report feeling some pain all the time and feel exhausted. The pain can vary from day to day depending upon weather changes, physical activity, and the presence of stressful situations. The pain is often more intense after disturbed sleep.

FATIGUE IN FM

Fatigue in FM can be more debilitating than the pain.

SLEEP PROBLEMS

Unlike in healthy people, sleep is unrefreshing and unrestorative.