Fibromyalgia Pressure Points

Fibromyalgia is a frequently seen disorder with the characteristics of long time widespread muscle and skeletal pain, rigidity, paresthesia, sleep disturbance, and easy fatigability. It mostly affects women compared to men in a ratio of 9:1.

Some patients might complain about the pain they feel at the lower back area which continues to the buttocks and legs. Some complain of aches and tightness in the neck area and across their upper posterior shoulders. Some may start to feel shoulder pain, neck pain/lower back pain before it eventually spreads throughout the whole body. Some may think that their joints are actually inflamed. Some may have lack of sensation on the hands and feet. These complain may be not stop and may only be due to mild effort.

The fibromyalgia pressure points are the characteristic features in the diagnosis of the said disorder. On physical examination, the specific sites that are more tender compared to same sites in normal individuals are demonstrated. With that, it is also called tender points. These areas are palpated using the hands with a modest and consistent amount of pressure. Ideally, the force applied should be 4 kilograms or approximately 9 pounds, the same degree of force to just blanch the thumbnail of the examiner. In eliciting tenderness, some may do a rolling motion palpation while some may use a spring-loaded pressure gauge called dolorimeter. The former may be more effective and accurate. The degree of tenderness or pain can be quantified but the number of tender point sites is more diagnostic.

As specified by the American College of Rheumatology criteria, the 18 fibromyalgia pressure points exist at nine locations in the muscle that are oppositely placed in the body. These include the following:
1. Area of the neck in front at lower cervical spine
2. Area of the chest in front at or around the most prominent bone
3. Area of the neck at the back just below the head
4. Area in the upper back
5. Area in the junction of the shoulders and neck
6. Area of the elbow
7. Area of the upper buttocks at the outer quadrant
8. Area of the hip under the buttock
9. Area of the knee above the joint

Each of these areas is about the size of a coin/penny. It requires the skills of a trained professional to accurately locate each point. When tested, you should only feel a slight pressure in these areas if you don't have fibromyalgia. On the contrary, an individual with fibromyalgia would feel pain at the manipulation site and an increase in overall body pain sensitivity.

Currently, doctors rely on the medical history of patient, observed symptoms and chief complaints, physical examination, and a precise manual assessment of tender points because there are no existing laboratory tests for diagnosing fibromyalgia. Tenderness pointed in eleven or more out of all above mentioned fibromyalgia pressure points with all over pain in all areas of the body (upper right, upper left, lower right, lower left) for a duration of three months or more is the diagnostic criteria for fibromyalgia.