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What Are Tender Points?

Common Symptom Associated With Fibromyalgia


Updated August 01, 2014

What Are Tender Points?
Photo by A.D.A.M.

Definition: Fibromyalgia is a soft tissue or muscular rheumatism, often called a rheumatic syndrome, with widespread pain in muscles, tendons, and other connective tissues, resulting in muscle pain without muscle weakness. Unlike some types of arthritis and rheumatic conditions, fibromyalgia does not cause joint deformities.

Tender points are specific places on the body (18 specific points at 9 bilateral locations) that are exceptionally sensitive to the touch in people with fibromyalgia upon examination by a doctor.

The nine bilateral muscle locations are:

  • Low Cervical Region: (front neck area) at anterior aspect of the interspaces between the transverse processes of C5-C7.
  • Second Rib: (front chest area) at second costochondral junctions.
  • Occiput: (back of the neck) at suboccipital muscle insertions.
  • Trapezius Muscle: (back shoulder area) at midpoint of the upper border.
  • Supraspinatus Muscle: (shoulder blade area) above the medial border of the scapular spine.
  • Lateral Epicondyle: (elbow area) 2 cm distal to the lateral epicondyle.
  • Gluteal: (rear end) at upper outer quadrant of the buttocks.
  • Greater Trochanter: (rear hip) posterior to the greater trochanteric prominence.
  • Knee: (knee area) at the medial fat pad proximal to the joint line.

Also Known As: tenderpoints, tender spots, trigger points (note: this is an incorrect term since referred pain differentiates trigger points from tender points) See: Trigger Points vs. Tender Points, from AAFP.org

Examples: More Illustrations/Images Showing Locations Of The Tender Points Of Fibromyalgia:


Tender Points in Fibromyalgia, Miryam Ehrlich Williamson mwilliamson.com, 1997

Fibromyalgia, The Merck Manual, February 1, 2003

Questions and Answers About Fibromyalgia, NIH Publication NO. 04-5326, June 2004

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