Fibromyalgia is a disorder of unknown cause involving chronic pain and fatigue. Drs. David Hellmann and John Imboden Jr., in "Current Medical Diagnosis & Treatment," write that a fibromyalgia patient's lab tests are normal and a doctor's physical examination will not reveal signs of inflammation. According to Dr. Goldenberg, writing in the medical database UpToDate, fibromyalgia is one of the most common causes of general muscle pain in women ages 20 to 55 years. One of the criteria for fibromyalgia is to have pain at specific sites called "tender points."
Tender Point: Between the Shoulder Blades
The areas underneath both shoulders are potential tender points, also sometimes known as trigger points. In anatomical terminology, this area referred to as the origin of the supraspinatus muscle under each shoulder. A patient with fibromyalgia, however, would describe pain and tenderness when this area is lightly pressed, or palpated.
Tender Point: Upper Part of the Outer Buttock
As with the other tender points in a potential diagnosis of fibromyalgia, these tender points are generally symmetrical on the body, which means that patients have pain on both aides. In this case, the patient may notice tenderness in the upper region of her buttocks. The official designation for this tender point is "upper outer quadrant of the buttock"; a patient will likely complain of pain when the upper area of her buttocks is palpated.
Tender Point: Inner Knee
Another common site for tenderness in people with fibromyalgia is on the inner part of their knees. The anatomical term for this tender point is the "medial fat pad of the knee."
Tender Point: Outer Elbow
A patient with fibromyalgia may come to the physician and notice pain in her outer elbows when the physician performs a complete examination. This is another tender point, known as "2 centimeters distal to the lateral epicondyle." Translating this phrase out of medical jargon, this simply refers to a small area of the outer elbow, just above the elbow joint.
Tender Point: Upper Shoulder/Lower Neck
A patient may commonly experience symmetrical pain in the area between the upper shoulder and base of the neck. This is actually part of a muscle called the trapezius muscle, specifically the "mid upper trapezius muscle," and is another potential trigger or tender point.
References
- "UpToDate"; Denise S. Basow: 2010
- "CURRENT Medical Diagnosis and Treatment"; Stephen McPhee et. al.; 2010
- Mayo Clinic: Fibromyalgia Tender Points
