Trigger Points and Tender Points: What’s the Difference?

Trigger Points and Tender Points: What’s the Difference?
When discussing fibromyalgia and myofascial pain disorder, the terms “trigger points” and “tender points” are a common source of confusion. Tender points are commonly associated with fibromyalgia, whereas trigger points are seen in both disorders. But while tender points and trigger points are often used interchangeably, they are not the same. Tender points Tender points are 18 specific places on the body that were previously the sole manual diagnostic criteria for fibromyalgia. If you had a history of widespread body pain for more than three months, and if your rheumatologist determined you were tender in at least 11 of these 18 places, you had fibromyalgia. If you had fewer than 11 tender points, you did not — it was as simple as that. Over time, however, it became apparent that tender points come and go. Some days a patient might have only nine or 10; at other times, the patient might have 15, or even all 18. Then other issues such as non-refreshing sleep, cognitive difficulties, irritable bowel syndrome, jaw pain, headaches, anxiety, and depression became recognized as fibromyalgia symptoms. The current diagnostic method for fibromyalgia is more comprehensive than before, and the tender point exam is one of several factors considered. Trigger points Trigger points are different from tender points. You may have many more of them, and they can be located in any of the 600 muscles of the body. A person who has myofascial pain syndrome can have multiple trigger points throughout the body. Each trigger point is a hard, sore spot within a skeletal muscle. Its distinguishing feature is referred pain; that is, the pain is felt in a remote location as well as locally. For example, my recent bout of occipital neuralgia involved two trigger points just b
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