Fibromyalgia Tender Points

Medically Reviewed by Carol DerSarkissian, MD on November 29, 2022
3 min read

People with fibromyalgia often feel different types of pain in their bodies. Along with widespread, deep muscle pain, it’s common to feel multiple tender points, too.

Tender points are areas of pain around joints, but not in the joints themselves. These places hurt when you press on them.

They’re often not deep areas of pain. Instead, they seem to be just under the surface of the skin. They’re scattered over the neck, back, chest, elbows, hips, buttocks, and knees.

The place that’s the most tender is usually very small, about the size of a penny. These spots are much more sensitive than other nearby areas. In fact, pressure on one of the tender points with a finger will cause pain that makes the person flinch or pull back.

Doctors don’t know what causes these pressure points. But they do know that their locations are not random. They happen in predictable places on the body. That means many people with fibromyalgia have similar symptoms with their tender points.

Your doctor can test the painful tender points during a physical exam. But you also need to tell them about the exact pain you feel in those areas. Tell them about your other symptoms of fibromyalgia, too, such as deep muscle pain, fatigue, and sleep problems. If you've been diagnosed with irritable bowel syndrome, let the doctor know. IBS sometimes coincides with fibromyalgia.

When a doctor tests tender points for pain, they will also check other non-tender places on your body called control points to make sure you don't react to these as well.

To get an official diagnosis of fibromyalgia, you must feel widespread pain for at least 3 months.

There are many ways to manage the pain of tender points from fibromyalgia, including both conventional and alternative therapies. It’s not clear why, but low doses of antidepressants sometimes seem to ease fibromyalgia pain and fatigue. However, the treatment for fibromyalgia and tender points involves a mix of medications, daily stress management, exercise, water exercises called hydrotherapy, and rest.

How you handle fibromyalgia pain at home is another important part of your overall treatment. For example, therapeutic massage can manipulate the muscles and soft tissues of the body to help ease pain, muscle tension, spasms, and stress.

Try putting moist heat on your muscles twice a day to ease deep muscle pain and stiffness. You can use a moist heating pad, warm bath or shower, or a heat "cozy" that you warm in the microwave.

It’s also important to manage your schedule and control your stress levels. Be sure to block out time each day to rest and relax. Avoid making too many commitments that can wear you out. You can also try relaxation exercises such as guided imagery, deep-breathing exercises, or the relaxation response to manage how you deal with stress.

Also, try to go to bed at the same time every night. It allows your body to rest and repair itself. And get regular exercise. It will help you manage the pain and other symptoms of fibromyalgia.

A number of things can make fibromyalgia symptoms worse. They include:

  • Anxiety
  • Changes in weather -- for example, cold or humidity
  • Depression
  • Fatigue
  • Hormonal changes, such as PMS
  • Infections
  • Lack of sleep or restless sleep
  • Emotional stress
  • Physical exhaustion
  • Not moving around enough