The fibromyalgia It is characterized by a pain generalized, but there are points distributed throughout the body in which the sensitivity is extreme. They are known as Fibromyalgia tender spots: 18 very specific and small areas in which the patient feels pain at the simplest touch, and that is why they are key to the diagnosis of this disease so difficult to identify.
"They are areas that are especially sensitive to pressure when we explore the patient. They are placed in different places, mainly in tendinous areas and muscular bellies of parts of the body subjected to constant load and mobility, "explains Dr. Javier Rivera, rheumatologist and spokesperson of the Spanish Society of Rheumatology (SER).
Where sensitive points are located in the body
In order to identify them it is important that we know how to distinguish them and locate their origin. So, these sensitive points of fibromyalgia They are located in the following areas of the body:
- The lower muscles of the neck.
- The upper chest area, just below the clavicle.
- The muscles at the base of the skull, in the neck.
- Trapezius muscles from the back to the shoulders.
- Above the spine of the scapula (between the shoulder blades).
- The inner area of the knees.
- The buttocks, in the upper third of the gluteal insertion, near the iliac crest.
- The elbows.
- The outer area of the hips.
One of the curiosities that present these sensitive points is that usually no physical alterations are detected in them, such as inflammation or redness, but the truth is that "the finger pressure at these points it triggers an intense pain that, on occasion, causes the patient with fibromyalgia to withdraw the limb abruptly and with an expression of intense pain ", adds Dr. Rivera. It does not always hurt everyone; One day the patient may feel more pain in some points and other days in others, and also the intensity of pain may vary, and there may be days top and days worse.
In those sensitive spots, the fibromyalgia sufferer experiences intense pain with the simple touch
For the spokesperson of the SER, it is convenient to differentiate these sensitive points from the so-called trigger points, which are other areas of the body that "under pressure also produce pain, but in this case an irradiation continues through the zone of sensory innervation of the nerve that we are pressing," he says. "They are typical of myofascial syndromes, a different entity," he adds.
Why sensitive points hurt in fibromyalgia
At present the true origin of that intense pain in those points is unknown, although there are many theories. "In fibromyalgia and other central sensitization syndromes, the response is superior to what would be expected because there is a alteration of pain pathways, central nuclei, neuronal circuits or cerebral neurotransmitters, which amplifies pain. The painful points are areas subjected to a mechanical overload where small lesions easily appear that would trigger this phenomenon of central sensitization, producing an amplification of the pain. Therefore, a person with fibromyalgia can have the same peripheral lesions as another person without this pathology. The difference is that it hurts more for the phenomenon of central sensitization, "says the spokesman of the SER.
But the pain is real and, as explained to us by Dr. Josep Blanch, of the Unit of Clinical Experience of Central Sensitization Syndromes of the Hospital del Mar in Barcelona, today "there are tests such as functional magnetic nuclear resonances that allow the brain to be visualized in front of a painful stimulus. "
If you compare those images in people with this disease and in other healthy ones, they look different. "In patients with fibromyalgia, the areas that are excited by pain are larger, different, and more intense. Who knows if in the future we can have some technique to demonstrate conclusively this serious health problem, "he says.