The Role of Trigger Point in Fibromyalgia

Various studies have found that trigger points plays a significant role in affecting pain in people with fibromyalgia. In a 2011 study published in The Clinical Journal of Pain, researchers were able to re-enact the spontaneous fibromyalgia pain in participants by manipulating their trigger points. They also observed a direct relationship between the number of active trigger points and the level of widespread pain experienced by participants. It was explained that local and referred pain caused by active trigger points can result in central sensitization, a phenomenon associated with fibromyalgia, where by the central nervous system becomes a lot more sensitive to pain and other stimuli including light, sound, temperature and touch etc.

The findings of this study are in line with earlier studies done in 2009 and 2010 which also support the theory that widespread active trigger points can lead to central sensitization. The 2010 study, conducted with 30 participants with fibromyalgia, found that most of the 18 specific locations of tender points lies in common myofascial trigger points sites and that the induced pain caused by the trigger points on tender points imitates overall fibromyalgia pain.

Distinguishing between the tender points and trigger points is important to determine an appropriate treatment. A polish article published in 2009 suggest that the inability to make a clear distinction between the two symptoms and terms can result in misdiagnosis and inappropriate treatment.

For fibromyalgia patients who have both, treating myofascial trigger points can significantly help in alleviating fibromyalgia pain and other symptoms.

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1. Alonso-Blanco C, et. al. Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. The Clinical journal of pain. 2011 Jun;27(5):405-13.
2. Ge HY, et. al. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome. Pain. 2009 Dec 15;147(1-3):233-40.
3. Ge HY, et. al. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points. The journal of pain. 2010 Jul;11(7):644-51.
4. Ge HY. Prevalence of myofascial trigger points in fibromyalgia: the overlap of two common problems. Current pain and headache reports. 2010 Oct;14(5):339-45.
5. Kuncewicz E, Samborski W. Tender points and trigger points - differences and similarities. Chir Narzadow Ruchu Ortop Pol. 2009 Nov-Dec;74(6):367-71. (Abstract referenced. Article in Polish.)
6. Mense S. Differences between myofascial trigger points and tender points. Schmerz. 2011 Feb;25(1):93-103. (Abstract referenced. Article in German.)