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Fibromyalgia Pain Points

Fibromyalgia Pain Points


By now, if you’ve started looking into fibromyalgia, you’ve probably heard the term fibromyalgia pain points. You may have been curious about pain points, also known as tender points and trigger points, whether or not you experience them, and what your tender points can tell your doctor about your fibromyalgia and how it is being treated.

Learn more about the history of counting fibromyalgia pain points when diagnosing patients, the function of tender points in fibromyalgia, and whether or not counting pain points is relevant today.

What are Fibromyalgia Pain Points?

One of the things that’s true in people with fibromyalgia is that they have a reduced threshold to pain. A gentle bump could go unnoticed by someone without fibromyalgia. However, that same level of touch could hurt far more to someone with fibromyalgia since they are more sensitive to pain.

Although fibromyalgia is a sickness recognised for generating broad pain, doctors used to notice specific body parts in fibromyalgia patients that seemed more sensitive to touch than those who don’t have this disorder. These locations were named Fibromyalgia Pain Points.

A pain point is a localised area of discomfort that is close to a joint but not the joint itself. When you press on them, they hurt. Even light finger pressure, such as a poke, might cause someone to cringe or flinch.

Hugh Smythe and Harvey Moldofsky, two Canadian doctors, presented fibromyalgia criteria based on the detection of these pain spots in 1977, which is when the name “pain points”. It appeared to be appropriate and eventually became the main diagnostic element of the 1990 fibromyalgia criteria.

Fibromyalgia pain points aren’t located randomly. They are small, roughly the size of a penny, and located in particular regions of the body. They aid in the distinction between those with fibromyalgia and those who are otherwise healthy.

Years ago, upon diagnosing fibromyalgia, doctors would count the patient’s pain points that generated agony. They might make a fibromyalgia diagnosis if 11 out of 18 fibromyalgia pain points proved sensitive.

Where Are Fibromyalgia Pain Points?

Fibromyalgia pain points frequently occur in pairs. They can be found around the neck, chest, shoulders, hips, and knees, both above and below the waist. When the doctor presses on the tender spot with enough effort to make their fingernail turn white, there should be pain there specifically. The area that is being pressed ought to hurt there.

Among the 18 fibromyalgia pain points are:

  • Arm near the elbow
  • At the bottom of the head in the back of the skull
  • Edge of upper breast
  • Lower neck in front
  • Knee
  • Hip bone
  • Upper outer buttock
  • Back of the neck
  • Back of the shoulders
What Causes Pain Points?

Although specialists are unsure of the precise cause, they believe that muscular spasms are to blame for certain sensitivity in particular places.

Muscle spasms [involuntary contractions] frequently result from a shortage of blood flow and oxygen. It’s a vicious cycle since the lack of oxygen and the accumulation of acid and carbon dioxide make the muscles more painful and more prone to spasms. The initial cause of muscle spasms is what? The cause of these spasms and heightened sensitivity is currently unknown. But a cyclical event is what’s creating the suffering.

Why Are Pain Points No Longer Counted Today?

Fibromyalgia is a difficult illness to diagnose because patients’ symptoms cannot be seen on the body, in blood tests, or in X-rays. A doctor, frequently a rheumatologist, must listen to a patient’s history and symptoms, including their intensity and duration, in order to diagnose fibromyalgia.

The 1990 Fibromyalgia Diagnostic Criteria stipulated that 11 of the 18 tender points had to be present and had been painful for at least three months. This included counting tender points.

However, the 2010 revisions to the recommendations removed the need that a diagnosis of fibromyalgia to be made by counting pain points. Numerous fibromyalgia sufferers were discovered to not match the tender points requirement.

Learn more about the current fibromyalgia diagnosis process.

Counting pain points correctly can be challenging, and experts disagree about their accuracy. It requires applying a particular amount of pressure, and some doctors apply more pressure than other doctors. It was discovered that pain point counting was not particularly helpful for diagnosis.

The issue with pain points is that they are highly subjective. How one applies pressure to a patient may differ from how another doctor applies pressure.

The fact that the location and intensity of fibromyalgia pain can change from day to day is another concern. A fibro sufferer may have intense pain in almost all tender sites in one day. They might only experience pain in a few on another day.

It was discovered by doctors that underdiagnosing too many individuals with fibromyalgia was caused by an overreliance on tender spots.

The earlier criteria, which focused on tender points, also disregarded other common chronic fibromyalgia symptoms like sleep problems, exhaustion, a lack of energy in the morning after resting, and cognitive problems like “fibro fog.”

The Widespread Pain Index (WPI), which evaluates where you experience pain in distinct sections of the body, was a factor in the most recent guidelines for diagnosing fibromyalgia in 2016. The WPI counts a “1” for each place. On a scale from 0 (no difficulties) to 3, the Symptom Severity Scale (SSS) score evaluates how the pain feels in terms of fatigue, cognitive symptoms, and how they feel when they wake up (severe and continuous).

The following factors are part of the most recent criteria for fibromyalgia diagnosis:

  • Doctors use the Widespread Pain Index and Symptom Severity Scale when (WPI) ≥7 and the Symptom Severity Scale (SSS) score ≥5, OR WPI 4–6 and SSS score ≥9.
  • Generalized pain, pain defined in at least four of five regions (left upper, right upper, left lower, right lower, low back) is present.
  • For at least three months the symptoms have been consistent
  • Counting tender points (not required)
These pain point locations are counted according to the diagnostic criteria used now and those from 2011 are the left upper body, right upper body, left lower body, right lower body, and the centre of the body (usually low back). The pain in the jaw, the abdomen, and the chest are no longer considered a criterion.
A diagnosis of fibromyalgia is valid regardless of other diagnoses, according to the 2011 criteria. A fibromyalgia diagnosis does not rule out the presence of other clinically significant disorders. This means that your doctor shouldn’t rule out fibromyalgia if you have been diagnosed with rheumatoid arthritis (RA), axial spondyloarthritis (AS), osteoarthritis (OA), chronic fatigue syndrome, lupus, or other illnesses.
What Is the Treatment for Pain Points?

In order to effectively treat fibromyalgia pain points, your fibromyalgia problem must be addressed as a whole. This may need a number of prescription medications and suggestions for lifestyle changes.

The following forms of medications may be suggested by doctors to treat sensitive point pain and fibromyalgia symptoms:

  • Antidepressants
  • Anti-seizure medications
  • Non-steroidal anti-inflammatory drugs
  • Injections of steroids or other medications

An injection might play a role if there is a particular muscle area that is more uncomfortable than others. Applying some local anaesthetic and corticosteroids to the affected area. Botox is also a good treatment to keep the muscle paralysed if the muscle is still in spasm and doesn’t respond to training and stretching. A trigger point or myofascial injection with a local anaesthetic and steroids.

Exercise in particular is crucial for controlling the symptoms of fibromyalgia. Lifestyle changes are also very significant. Numerous fibromyalgia-related problems, such as anxiety, sadness, pain, and exhaustion, can be helped by exercise.

Regular aerobic exercise and muscle-building exercises can be beneficial. The ability to manage stressors is crucial. We know that stress has a significant role in the development of fibromyalgia in some individuals.

Acupuncture, massage, acupressure, physical therapy, yoga, and cognitive behavioural therapy are examples of complementary treatments for fibromyalgia pain management.

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