When pressure is applied to a certain area, it can cause deep and painful muscle pain, known as a tender point or trigger point. Fibromyalgia pain is different because it is widespread, migratory, and affects both muscles and joints. It affects both sides of the body, above and below the waist. Trigger points are defined as areas of the muscle that are painful on palpation and are characterized by the presence of tight bands and the generation of a reference pain pattern.
Tender spots, on the other hand, are areas of tenderness that occur in the muscle, the junction between the muscle and the tendon, or the pouch or adipose pad. When tender spots occur in a generalized way, they are generally considered to be characteristic of fibromyalgia. Trigger points, which usually occur in a more restricted regional pattern, are indicative of myofascial pain syndrome. In some cases, both phenomena may coexist and overlapping syndromes may occur.
Reliability among evaluators of trigger points has been low in most studies. There is ongoing controversy over the defining characteristics and homogeneity of myofascial pain due to the variability of exam findings. In appropriately selected patients, it appears that Trigger Point myofascial injections may be useful in reducing pain and improving range of motion, along with a comprehensive exercise and rehabilitation program. They cause local pain when pressed.
Tender spots are used to help diagnose fibromyalgia. There are 18 specific sensitive points located in nine bilateral locations that cause pain when they weigh four kilograms (or about 10 pounds). A trigger point is a place on the body that, when pressure is applied, redirects (or triggers) pain to another part of the body. It's important to learn to differentiate between tender points and trigger points so you can provide your chiropractor with accurate information.
The American College of Rheumatology included counting tender points in its 1990 fibromyalgia diagnostic criteria, stating that 11 of the 18 tender points had to be present and cause pain for at least three months. If you gently massage your sensitive muscles and find a lump or knot that radiates pain when you press on it, you've found a trigger point. While the diagnosis of FM or MPS requires a detailed clinical examination by a primary care physician, rheumatologist, or pain specialist, a key diagnostic difference lies in the identification of the PMS trigger points and the tender points of FM. The tender points of FM differ from the activation points of MPS in that they represent areas of the muscles that are exquisitely sensitive and painful with simple manual pressure.
It is very important to have someone expert in evaluating the difference between a sensitive point and a trigger point because the treatments are very different. It's not unusual for a person with fibromyalgia to also have MPS, which may be one reason why tender points and trigger points are often confused. Topical capsaicin or lidocaine applied to the skin above the trigger point may also be used to treat MPS.
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