Fibromyalgia tender points

Fibromyalgia Tender Points

Fibromyalgia Tender Points

Table of Contents

There are eighteen fibromyalgia tender points within the body. These are points that are extra sensitive to pain for people that have fibromyalgia. This is a complex condition that is hard to diagnose, but it affects nearly 2% of Americans each year.

What is Fibromyalgia?

Fibromyalgia is a chronic pain disorder that affects the bones, muscles, tendons, and joints. It is the second most frequent condition that impacts the muscles and bones (Bruce, 2019). Fibromyalgia is made up of several different symptoms that tend to fall under three categories: widespread pain, cognitive issues, and chronic fatigue. Fibromyalgia is a very difficult condition to pinpoint because there is no test for it.

What Causes Fibromyalgia?

One of the main reasons for this disorder is because doctors are not sure what causes fibromyalgia. There have been some links to certain genes, and the condition does happen genetically in clusters, but it does not pass down directly from parent to child. Some things that make someone more susceptible to developing fibromyalgia are as follows:


  • Being a woman
  • Having arthritis or other diseases dealing with pain
  • Having depression or anxiety
  • Physical or emotional trauma/PTSD
  • Lack of exercise
  • Family link

Signs of Fibromyalgia

Fibromyalgia affects the nervous system and the brain, causing people to have a lower pain tolerance. Many people will experience digestive issues, sleep issues, chronic pain especially in specific tender points, and cognitive difficulties.

First Signs

One of the earliest signs of fibromyalgia is fatigue. Fibromyalgia causes a lot of sleep issues such as non-restorative sleep, restless leg syndrome, and other sleep disorders. They will also experience muscle twitches and cramps, and they will struggle with numbness or tingling inside of their extremities.


The individual might experience some memory issues and mental health conditions such as depression and anxiety. Many of the symptoms will continue to worsen over time, and eventually, they will interfere with day-to-day activities.

Fibromyalgia Pain Points

One way that doctors tend to check for fibromyalgia is by putting pressure on the tender points. Fibromyalgia causes people to have lower pain tolerance, making things as simple as brushing up against a person, a waistband, or even a shirt tag feels very painful. These tender points are in the shoulders, back and front of the neck, arms, knees, hips, and lower buttocks. Although doctors aren’t sure why these areas are sensitive for people who have fibromyalgia and not others, they do know that it has something to do with spasm.1

Cognitive Difficulties

A person with fibromyalgia will face some cognitive difficulties as well. People who have fibromyalgia have “impairments in working, episodic, and semantic memory that mimic about 20 years of aging.”2 These cognitive difficulties are most likely caused by brain abnormalities in areas that deal with pain. Someone who is developing fibromyalgia will most likely start having issues with memory and seem like they are in a fog. This issue is known as fibrofog, which also causes a person to have issues with switching between tasks and paying attention.2

Symptoms of Fibromyalgia

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Fibromyalgia affects numerous functions of the body. Because it targets the nervous system, its effects can be felt in several different areas. The main issues people are going to face are pain and fatigue. However, there are numerous ways that digestive issues, sleep issues, numbness, and cognitive difficulties will affect the person, especially if it goes untreated.

Chronic Pain Symptoms

Fibromyalgia is a chronic pain disorder. The pain is widespread, which means it is felt on both sides of the body and below and above the waist. Something that would normally be painless for a person becomes extremely painful for people with fibromyalgia. The condition also causes spasms, twitches, and cramps which can all lead to more severe pain for the person.


This condition affects sleep patterns. Because the pain is chronic and doesn’t ever fully go away, it can cause issues with maintaining sleep. Fibromyalgia ends up having very similar symptoms to chronic fatigue disorder. Many times, it can coincide with sleep apnea and restless leg syndrome. Additionally, people might struggle with nonrestorative sleep.


People might also struggle with numbness within their arms and legs. Many people compare this numbness to the feeling they get when their foot falls asleep or right afterward when the blood comes rushing back in. This numbness might happen more frequently and last longer.

Digestive Problems

Over 50% of people who have fibromyalgia also have symptoms of irritable bowel syndrome. It will lead to symptoms such as diarrhea, constipation, bloating, gas, stomach aches, and nausea. Many times, these conditions co-exist with one another, so it is important to keep track of any issues that you might be happening.

Nonrestorative Sleep

Finally, most people struggle with nonrestorative sleep, which is when you sleep through the night, but when you wake up, you feel as if you did not get any at all. It is normally due to spasms and aches breaking up your sleep cycles throughout the night causing you to toss and turn. Other sleep disorders can coincide with fibromyalgia, so there is always a chance for that to make the troubles that much worse.

Where Are Fibromyalgia Tender Points?

There are eighteen main tender points throughout the body for people who have fibromyalgia. These pain points are all around different joints throughout the body, and scientists believe they are caused by muscle spasms. They are the main distinguishing spots between a person who has fibromyalgia and someone that does not. If a person were to press on any of these areas, the person who has fibromyalgia will feel a sharp pain even with the slightest pressure.3

The Eighteen Tender Points

Four of the tender points occur around the neck area right underneath the jaw and at the bottom of the skull. There are also four pain points located around the shoulder blades and two at the upper part of the breastplate. The next main tender points are located outside of the elbow and near the knee. Finally, the last four points are located at the top of the hips and the lower side of the buttocks.

What Foods Trigger Fibromyalgia Pain?

Several foods can trigger fibromyalgia pain and cause digestion issues. However, the level at which these foods affect a person varies. Many doctors will suggest that a patient goes on an elimination diet to figure out what makes their pains worse and what has little effect on them.

Elimination Diet

During the elimination diet, one will cut out several different foods, and they will reintroduce the foods one at a time. This diet allows someone to track down how each one makes them feel and if it worsens the pain. Several people do this for other reasons, too. Here are a few of the foods that get cut out.


According to Medicine Net, “Studies have shown that non-celiac gluten sensitivity may be an underlying cause of fibromyalgia.”5 They found that people who ate a gluten-free diet had less pain and saw an increase in their quality of life. This makes gluten a very important food to try eliminating during the elimination diet.

Refined Carbohydrates

Taking away things such as white rice or bread can reduce pain and other symptoms related to fibromyalgia. One of the reasons that taking these foods away can help is because these foods break down quickly. The spike in blood sugar that occurs can cause a lot of pain and fatigue. Eating these foods might disturb normal sleep cycles and cause weight gain, both of which hurt people who have fibromyalgia.4

Oily Foods

These kinds of foods can have an inflammatory effect on the body, it can increase fibromyalgia symptoms.5 Avoiding foods that are oily and high in fat can greatly improve your day-to-day living with fibromyalgia.


Some studies show that moderate use of alcohol or less made eased symptoms in some people, but alcohol also caused more issues for other people. Because alcohol is a depressant, it can negatively impact the medications you will need to take, making the symptoms worse.


Caffeine simply raises your heart rate and blood pressure. This extra stress causes a strain on your muscles, causing more pain to flow throughout your body. As such, people with fibromyalgia should always avoid caffeine.

Treatment for Tender Points

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There are multiple ways to treat fibromyalgia tender points, including:


Any fibromyalgia pain plan will require a mix of medications. Normally, an antidepressant will be used to ease some of the pain. There might be a couple of other prescriptions used to treat symptoms that are specific to your case.


Cognitive-behavioral therapy helps people to learn several different ways to change their behaviors to adopt healthier options. A person with fibromyalgia might go to CBT to learn how to manage stress better, have mental health reasons, or even learn new habits.


Studies have shown that yoga can help lower stress inside of patients who experience fibromyalgia. Going to yoga twice a week can greatly lower the amount of pain you feel and increase your ability to do normal day-to-day activities.


Exercise can do the same thing as yoga when it comes to reducing stress. Some people become nauseous after exercise, so it is important to monitor yourself as you do it. However, higher amounts of exercise lower someone’s chance of developing fibromyalgia. It also helps treat some of those tender points.

Stress-Reduction Techniques

Stress-reduction techniques can help a person take away pressure through simple breathing techniques. These techniques help take some of the pressure off the tender points and refocuses the mind. These stress reduction techniques will also lower blood pressure, which also lowers the amount of pain a person feels.


An alternate therapy a person might try is acupuncture. Studies have shown that acupuncture can offer symptom relief for fibromyalgia. According to one study, people reported their pain to be 13% less than those who did not use acupuncture after six sessions.5


Finally, going to see a chiropractor might help. Some clinics specialize in fibromyalgia. The goal of chiropractic work is to strengthen the client and help them with flexibility. The use of this method can help relieve pain for patients over time and teach them different exercises and stretches to help them learn how to cope with having fibromyalgia.

Fibromyalgia is a difficult disease to diagnose. One thing that distinguishes it between regular people is the eighteen tender points. Seeking a diagnosis and treatment to help with these symptoms is the first step to finding healing.