What Are Fibromyalgia Trigger Points?

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One of the reasons fibromyalgia pain is different is because it involves trigger points. When activated, these locations can cause significant pain in seemingly unrelated areas.

To better handle these propagators of pain, it is important to have a solid understanding of fibromyalgia and its trigger points as well as methods of limiting their impact.

A Quick Look at Fibromyalgia

Fibromyalgia is a chronic condition that is incredibly difficult to treat. This long-lasting disease presents a wide range of symptoms that vary from patient to patient. The intensity of which can range from mild to severe and often changes on a daily basis. There are many symptoms that accompany fibromyalgia including headaches, sleep disorders, fatigue, and various mental disorders. However, the most common and distinctly noticeable symptom of fibromyalgia is widespread tenderness and pain.

Doctors and patients alike often use specific painful locations around the body, known as tender points, to diagnose fibromyalgia. The 18 tender points are located on both side of the body in the following areas: neck, chest, shoulder, elbows, hips, knees, above and below the waist, and the back of the head. When someone is suffering from fibromyalgia, these areas typically produce significant localized pain when pressure is applied. Tender points are an expected symptom of fibromyalgia but there is another that may be an even greater contributor to fibromyalgia pain.

What Are Trigger Points?

Fibromyalgia can cause painful knots to develop in muscle tissue called myofascial trigger points. When these clumps of tissue are aggravated, they can trigger intense pain and inflammation in soft tissue. This is a primary component of fibromyalgia pain. Some studies suggest that they may actually be the cause of the better-recognized tender points.

Unlike tender points that cause localized pain when activated, trigger points can induce referred pain elsewhere in the body. Referred pain is a sensation similar to shooting or radiating discomfort that occurs in a location apart from the source. For example, a person who hits their elbow and feels pain in the hand or arm is experiencing referred pain.

Fibromyalgia patients may have both tender and trigger points that contribute to their overall pain. The Journal of Pain produced a study that found most tender points are also myofascial trigger points. This would explain why fibromyalgia patients with many tender points may experience pain in seemingly disconnected regions.

Trigger points are most commonly seen in patients with myofascial pain syndrome (MPS). Although it is a separate condition it can coexist with fibromyalgia. Furthermore, fibromyalgia may prompt the development of MPS. Even though trigger points are far more common among fibromyalgia patients, anyone may develop them.

Tips on Treating Trigger Points

Because trigger points are a major component and contributor of fibromyalgia pain learning how to alleviate the significant discomfort and reduce the risk of aggravating these sites is important to improving patient quality of life. There are multiple approaches to calming trigger points and limiting their response. Fibromyalgia patients may find that some or all of the following treatments can provide relief of trigger point pain.

Trigger Point Injections

Trigger point injections can be administered to reduce trigger point reactivity and intensity. This treatment typically includes substances such as saline, steroids, or local anesthetics. Pain therapies utilize specialized equipment to administer trigger point injections. This therapy is relatively uncommon. Therefore, it may be beneficial to ask a doctor to help locate a specialist who is equipped and qualified to administer trigger point injections.

Massage Therapy

Studies have found that certain types of massage can greatly benefit fibromyalgia pains. According to the Journal of Manipulative and Physiological Therapeutics, manual lymph drainage therapy and connective tissue massage are useful in alleviating fibromyalgia trigger points.

Manual lymph drainage therapy involves removal of fluids away from areas that have blocked or damaged lymph vessels. Malfunctioning lymph vessels can result in pooling of fluids that can contribute to inflammation and pains. Connective tissue massage is similar to a more traditional massage in that it uses intense pressure focused on specific myofascial regions to break up knots. Research has found that use of both techniques can reduce pain, support a better quality of life, and improve one’s pain threshold.


This ancient Chinese method of pain relief has been used for thousands of years to great effect. In recent year, acupuncture has become a frequently used method for treating pains associated with fibromyalgia. Acupuncture points are shared with many fibromyalgia tender points and myofascial trigger points. The focused pressure provided by acupuncture can help break up inflammation in these areas, improve the body’s response to pain, and stimulate blood flow to help repair nerve damage. These factors all aid in limiting the pain caused by trigger points.

Pain Medications

Fibromyalgia patients frequently experience greater pain sensitivity. Because of this, doctors may prescribe over-the-counter prescription pain medications to help alleviate pain associated with trigger points and fibromyalgia. Some common recommendations include milnacipran and duloxetine, which impact brain chemistry to help the body better manage pain levels. Pregabalin is another frequent recommendation that inhibits pain transmission by nerve cells. These medications can reduce the overall impact of trigger points but do not provide a true solution.

Final Points on Fibromyalgia

Fibromyalgia pain involves many different factors. Of these, trigger points are perhaps the most influential regarding the occurrence of significant fibromyalgia pain. Being well-informed of what trigger points are and how they impact the body can prove to be highly beneficial for treatment.

Reducing the reactivity and intensity of trigger points by using the various therapies mentioned above can help alleviate pain and even improve the efficacy of fibromyalgia treatment. Support your health and achieve a better quality of life by limiting the effects of trigger points and fibromyalgia.


1. Fibromyalgia Pain. FibroCenter. https://www.fibrocenter.com/fibromyalgia-pain

2. Managing fibromyalgia tender points. Medical News Today. https://www.medicalnewstoday.com/articles/315594.php

3. What Are Fibromyalgia Tender Points? Healthline. https://www.healthline.com/health/fibromyalgia/fibromyalgia-tender-points

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

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