The Difference Between Tender Points and Trigger Points

When people talk about fibromyalgia, they
sometimes use the terms tender points and trigger points
interchangeably. In actuality, they have quite different meanings. All
accurately diagnosed FM patients have tender points; some may also have
trigger points.

Tender Points

Tender points are used to help diagnosis
fibromyalgia. They are extremely sensitive spots on the body that
elicit pain when four kilograms (or about 10 lbs.) of pressure are
applied. There are 18 specific tender points located at nine bilateral
locations.

Tender points occur on both the right and left sides of the body at these nine locations:

1. 
   Occiput: bilateral, at the suboccipital muscle insertions. (Where the neck muscles attach at the base of the skull)
   
2. 
   Low cervical: bilateral, at the anterior aspects of the intertransverse spaces at C5-C7. (Front lower neck)
   
3. 
   Trapezius: bilateral, at the midpoint of the upper border. (Midway between the neck and shoulder)
   
4. 
   Supraspinatus: bilateral, at origins, above the scapula spine near the medial border. (Muscle over the upper inner shoulder blade)
   
5. 
   Second Rib: bilateral, at the second costochondral junctions, just lateral to the junctions on upper surfaces. (Edge of upper breast bone)
   
6. 
   Lateral epicondyle: bilateral, 2 cm distal to the epicondyles. (2 cms below side bone at elbow)
   
7. 
   Gluteal: bilateral, in upper outer quadrants of buttocks in anterior fold of muscle. (Upper outer buttock)
   
8. 
   Greater trochanter: bilateral, posterior to the trochanteric prominence. (Hip bone)
   
9. 
   Knee: bilateral, at the medial fat pad proximal to the joint line. (Just above the knee on the inside)