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Diagnosing Fibromyalgia through Tender Points

Posted by Dr. Serge Lanoue on 12 January 2017

Fibromyalgia can affect sufferers in many different ways. You might be feeling tired, your jaw might hurt, or you might experience numbness or light-headedness. The complexity of fibromyalgia is reflected in the diagnosing process which can take up to 4 years to accurately diagnose. Common symptoms like fatigue, skin sensitivities, dizziness, chronic headaches or memory impairments are usually trigger symptoms that may help guide your family physician in the right direction for diagnosis. However, because the symptoms can be quite vague it is commonly thought to be other conditions. Some symptoms of fibromyalgia are shared with other diseases such as anemia, hypothyroidism or allergies.  The key diagnosing factor is tender points.

What are Tender Points

Though fibromyalgia is characterized by widespread pain in all four quadrants of the body, tender points are much more sensitive than other nearby areas. Pressure placed on a tender point can cause flinching or pulling away from the cause of the strain. These tender points play a big role in the diagnosis of fibromyalgia because pain is subjective and one person's generalized pain may not equate to someone else's generalized pain.

There are a total of 18 tender points (or 9 pairs) on the body. They are typically located near the joints but not inside the joints themselves and tend to be very small. These pairs of tender points are symmetrically positioned on the body. They are not areas of deep pain but are seemingly just under the surface of the skin and pressure will cause intense pain. For a correct diagnosis, 11 tender points need to be present. Because the position of these points is not random they are currently the most predictable reference to help with a correct diagnosis. So where are these tender points? The 9 pairs are located at:

  1. The Back of the Neck: Located at the cervical right base of the skull where it meets the neck.
  2. The Front of the Neck: The low cervical pain point located above the collarbone on either side of the larynx.
  3. The Chest: Located at the second rib, this pair of tender points is located on either side of the sternum and only a few inches below the collarbone.
  4. The Upper Back: The tender points in the upper back are located where the back muscles connect with the shoulder blades in the upper back at the supraspinatus.
  5. The Shoulders: Just above the upper back, there is a second set of tender points at the trapezius, about half way between the edge of the shoulder and the bottom of the neck.
  6. The Elbows: The lateral epicondyle is located at the inner forearm near the crease of each elbow.
  7. The Lower Back: Even though lower back pain is common, the tender points for fibromyalgia are located at the very top of the buttocks right at the bottom of the lower back and is commonly thought of as a gluteal tender point.
  8. The Hips: Pain in the hips for fibromyalgia sufferers tend to be localized towards where the buttock muscles curve to join the thighs at the greater trochanter.
  9. The Knees: These pain points are located on the inner side of the knee by the pad that lies over the joint line.

Chiropractic Treatment May Help Manage Tender Point Pain

Chiropractic care for fibromyalgia is rooted in the very core of the chiropractic belief that a strong skeletal structure is essential to a strong body. Balancing structure through stretches and adjustments, fibro pain may be alleviated successfully. A lot of fibromyalgia tender points are centered around the spine and proper spinal manipulation may help decompress these areas near the neck and head to alleviate some of the chronic pain associated with the condition.

By firstly assessing spinal alignment and muscles as well as checking these 18 tender points, chiropractic care can hone into the correct treatment plan that may help ease fibromyalgia symptoms. When pain associated with fibromyalgia is reduced, other symptoms such as fatigue and depression may also reduce to improve overall quality of life.


The best thing you can do if you suffer from fibromyalgia is incorporate chiropractic care into your pain management toolbox. Schedule your assessment with Dr. Serge Lanoue to improve your fibromyalgia symptoms.



Dr. Serge LanoueAuthor:Dr. Serge Lanoue
About: Since 1990, Mississauga chiropractor Dr. Serge Lanoue has been helping patients feel better through time-tested chiropractic techniques. Dr. Lanoue and his team have worked with patients on a number of physical issues from back pain to rheumatoid arthritis to tennis elbow to migraines. Our patients are looking to live healthier lifestyles without relying so much on prescriptions or surgeries to heal injuries. Chiropractic therapy is a more natural treatment option.
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