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The pain of Fibromyalgia (FM) is present in the soft tissues throughout the body. Pain and stiffness concentrate in spots such as the neck and lower back. The tender spots don't seem to be inflamed, nor do they display the typical signs of discomfort, such as heat, redness, or swelling. Most tests show nothing out of the ordinary in the anatomy of people with FM.

The anatomy of FM is rather straightforward: there are 18 tender points (often confused with trigger points, which are associated with chronic myofascial pain) on your body that doctors have identified. These tender points become painful when pressed on (that's part of the American College of Rheumatology diagnostic process for fibromyalgia). According to the ACR criteria, FM is present when a patient suffers widespread pain for at least three months and feels pain in 11 or more of the 18 pressure point sites.

Doctors measure these tender points in one of two ways:

  • By pressing the site with a finger or
  • By using a slightly higher-tech method called dolorimetry

In the dolorimetry method, the examiner presses a rubber endplate, attached to a spring-loaded force gauge, into the tender point site with increasing force. Patients are then asked to say when they stop feeling pressure and start feeling pain.

These tender points are very small, about the size of a penny. All of them are around joints, however, FM pain has nothing to do with the joints themselves. Instead, FM pain affects the soft tissues of your body, mainly the muscles.

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  • The american college of rheumatology 1990 criteria for the classification of fibromyalgia, Frederick Wolfe, Hugh A. Smythe, Muhammad B. Yunus, Robert M. Bennett, Claire Bombardier, Don L. Goldenberg, Peter Tugwell, Stephen M. Campbell, Micha Abeles, Patricia Clark, Adel G. Fam, Stephen J. Farber, Justus J. Fiechtner, C. Michael Franklin, Robert A. Gatter, Daniel Hamaty, James Lessard, Alan S. Lichtbroun, Alfonse T. Masi, Glenn A. Mccain, W. John Reynolds, Thomas J. Romano, I. Jon Russell, Robert P. Sheon, Arthritis & Rheumatism, Volume 33, Issue 2 , Pages160 - 172, American College of Rheumatology.
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