How To Tell the Difference Between Myofascial Trigger Points and Fibromyalgia Tender Points

Posted on 22 Dec 2010 02:14

The terms trigger points and tender points are often used interchangeably. However, they are two different things and it is very important to understand the difference, especially if one suffers from a condition known as Fibromyalgia Sydrome.

What is Fibromyalgia Syndrome?

Fibromyalgia syndrome is a common and chronic condition marked by widespread pain, diffuse tenderness, and many other symptoms. The word “fibromyalgia” comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia).

Although fibromyalgia is often considered an arthritis-related condition, it is not truly a form of arthritis (a disease of the joints) because it does not cause inflammation or damage to the joints, muscles, or other tissues. Like arthritis, however, fibromyalgia can cause significant pain and fatigue, and it can interfere with a person’s ability to carry on daily activities. Also like arthritis, fibromyalgia is considered a rheumatic condition, a medical condition that impairs the joints and/or soft tissues and causes chronic pain.

In addition to pain and fatigue, people who have fibromyalgia may experience a variety of other symptoms including:

* cognitive and memory problems (sometimes referred to as “fibro fog”)
* sleep disturbances
* morning stiffness
* headaches
* irritable bowel syndrome
* painful menstrual periods
* numbness or tingling of the extremities
* restless legs syndrome
* temperature sensitivity
* sensitivity to loud noises or bright lights.

Fibromyalgia is associated with 18 tender point sites that appear in certain areas. These tender points, unlike myofascial trigger points, do NOT refer pain to other areas of the body.

What's the Difference Between Trigger Points and Fibromyalgia Tender Points?

Trigger points can be found anywhere on the body and their distinguishing characteristic is that they refer pain to other areas. Although this referred pain pattern is usually to an adjacent area it is possible for the pain to be referred to more distant areas, such as an abdominal trigger point referring pain to the back or even to organs.

As stated above, fibromyalgia tender points do NOT refer pain and they tend to appear in certain areas. These 18 areas are common enough to make up part of the diagnosis of fibromyalgia. These 18 points, which comprise nine paired points, are shown in the image below.

18 tender points of fibromyalgia

To meet the strict criteria for a fibromyalgia diagnosis, a person must have 11 or more tender points, but often patients with fibromyalgia will not always be this tender, especially men (see illustration below). People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.

Tender points will be much more 'tender' to touch then trigger points. Trigger points need a good bit of pressure to elicit pain. When enough pressure is applied then the referred pain pattern that was the original complaint may be “triggered”. A fibromyalgia tender point on the other hand does not need much pressure and sometimes a mere touch can cause excruciating pain.

Misdiagnosing fibromyalgia as myofascial trigger points is just as bad as treating these “points” as if they were trigger points. This could well elevate suffering to an unbearable degree. Although massage has been reported to be of some benefit to fibromyalgia sufferers, at least anecdotally, digging away at a tender point because one thinks it is a trigger point would simply cause crippling pain which might well linger for a long time.

Now, if you do have fibromyalgia you may well have trigger points as well. Identifying and treating the trigger points properly could alleviate some of the pain. It is after all, possible, to feel pain that is not caused by your fibromyalgia syndrome. For more article and information on myofascial trigger points see the trigger point category here at Ground Up Strength.

For more information on fibromyalgia see the American College of Rheumatology (ACR) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)


"Q&A Fibromyalgia." Arthritis, Musculoskeletal and Skin Diseases Home Page. Web. 21 Dec. 2010. <>.

This page is provided by Ground Up Strength for information purposes only and should not take the place of professional medical advice. Although we have done our utmost to provide accurate and safe information, we are not medical professionals and the information on this page should not be taken as professional medical advice, or any other kind of medical advice.

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