1. Consider Other Symptoms
Painful trigger points associated with fibromyalgia can often be identified because of associated symptoms that range from depression to fatigue and pain. Trigger points can be identified by their location, number of points present, and what end effect these points create when stimulated by touch or pressure. Determine if trigger points cause pain elsewhere in the body, or if the pain is radiating in nature. Fibromyalgia trigger points can also emerge as a result of some traumatic incident such as a car accident or other injury-causing episode; pain can be similar in type and location, but will ease with healing from an injury. If the presence of these painful areas is seen in association with overall chronic fatigue, bloating, sleep problems, frequent migraines or stiffness after sitting, they may well represent trigger points.
2. Pay Attention to the Location
More often than not, fibromyalgia trigger points are located throughout the upper and lower extremities, shoulders and neck, and are more commonly seen on both sides of the body. One of the most common sites for these trigger points is in the upper back region, between the shoulder blades and the spinal column. These points can also be found in the trapezius muscles on either side of the base of the neck. Myofascial Pain Syndrome, which can be confused at times for fibromyalgia, tends to display "trigger points" located directly within the muscle tissue itself, whereas fibromyalgia trigger points can be located in other tissues such as subcutaneous fat, skin and tendons. Trigger points differ from ordinary tender points in that when pressure is applied to the trigger point, patients often describe pain in other areas.
3. Look for the "Jump Sign"
Trigger points found in patients with suspected fibromyalgia display different, unique characteristics than those found in similar pain syndromes. This characteristic is commonly referred to as the "jump sign." The jump sign can be elicited when pressure is applied to a suspected trigger point, causing radiating pain into the area emanating from the point and a localized "twitch" response that in turn causes muscle fibers to shorten and the area to "jump." Because of the radiating nature of the pain when a trigger point is compressed, it's not unusual for an examiner to witness an entire extremity moving. Jump signs can manifest in virtually any place on the body, from the shoulders to the neck to the lower extremities. The presence of such signs is one major way of differentiating between fibromyalgia and other pain syndromes.
