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.
- Muscles Affected By Fibromyalgia Tender Points, from AAFP.org
- General Locations Of The 18 Fibromyalgia Tender Points, from Caring Medical Center
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