Is it fibromyalgia if I have zero tender points?

passowac

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I was recently diagnosed with fibromyalgia after extensive testing with very little results. I do have an elevated ESR, mildly decreased kidney function, and low vitamin D levels. I have very intense pains, mostly in my arms and legs, that come and go multiple times a day. The doctors have not been able to find a cause for my pains so they've diagnosed fibromyalgia. My problem with the diagnosis is I do not have any muscle-type pain or tenderness which a lot of you describe. Is it possible to have fibromyalgia without any tenderness?
 

sunkacola

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Fibromyalgia is such an umbrella diagnosis that a huge range of symptoms is found among those of us who have it. There is no one set of symptoms that is required to have in order to be diagnosed with fibro. If your doctor has made that diagnosis after doing tests for all of the other things that could be causing your pain, then that is probably accurate.
 

Drtohelpfibro

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The diagnosis is made by a careful history and physical exam and appropriate tests which typically includes a thyroid panel, sed rate, cbc and CMP.
In the past the diagnosis included tender points but because the reliability varied from doctor to doctor and tender points can vary from one week to another it is no longer used, although many doctors may not be up to date and continue to use them.
Now there is the 2016 American College of Rheumatology criteria involving the Widespread Pain Index (WPI) and Symptom Severity Score (SSI) that are used to make the diagnosis. Many with fibromyalgia will report pain but not necessarily tenderness.
As a supplement, I also use the Fibromyalgia Impact Score- Revised to help assess the severity/intensity of fibromyalgia. This is very helpful to me, as a physician, and my patients because any intervention, whether lifestyle or medication, can be assessed at followup visits to see if there is improvement. Most interventions I use with patients give partial benefit that varies from 20-50% reduction in FIQR scores.
Dr. Michael Lenz, MD

BTW , that was a great question. Feel free to reach out to me if you have any others.
 

Forgetmenot

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Well I don’t have tender points .only in the shoulders ,and I think that’s my boobs ,you knew the bra straps
Never had them .so it’s normal don’t worry .
I say don’t worry fibro isn’t anything to be laughed at.As someone has already said fibromyalgia has a Myriad of pain and aches .from mild ones and bigs ones ,ones that stay a day ,and ones that’s stay for months .it moves everywhere for some ppl .and stays with you in some parts for ever.
 

Jade

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I have fibromyalgia and have never had tender points. Mine is mostly nerve pain like shock, tingling, numbness, hyper sensitive nerves , sensitive to smell, light ect ... I could go on and on with more symptoms. I’ve had all nerve tests done through neurologists and everything comes back normal. My primary care doctor diagnosed me ( she also has fibromyalgia .)
So yes you can have fibromyalgia without tender points.
 

Bezbop

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Hello
The diagnosis is made by a careful history and physical exam and appropriate tests which typically includes a thyroid panel, sed rate, cbc and CMP.
In the past the diagnosis included tender points but because the reliability varied from doctor to doctor and tender points can vary from one week to another it is no longer used, although many doctors may not be up to date and continue to use them.
Now there is the 2016 American College of Rheumatology criteria involving the Widespread Pain Index (WPI) and Symptom Severity Score (SSI) that are used to make the diagnosis. Many with fibromyalgia will report pain but not necessarily tenderness.
As a supplement, I also use the Fibromyalgia Impact Score- Revised to help assess the severity/intensity of fibromyalgia. This is very helpful to me, as a physician, and my patients because any intervention, whether lifestyle or medication, can be assessed at followup visits to see if there is improvement. Most interventions I use with patients give partial benefit that varies from 20-50% reduction in FIQR scores.
Dr. Michael Lenz, MD

BTW , that was a great question. Feel free to reach out to me if you have any others.
Dear Doc, might you lead me to the publications/guidance dealing with the points you mention? I would like to educate my GP. Thanks, Liz
 

Bezbop

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Hello

Dear Doc, might you lead me to the publications/guidance dealing with the points you mention? I would like to educate my GP. Thanks, Liz
You can find my email online,
Liz Kuney, Medical Writer
 

Forgetmenot

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If u mean the tender points .which I believe they don’t use quite so much now,it’s
Shoulder
Back of neck
Back
Elbows
Back of knees
Hips
And coller bones
 

JayCS

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I have very intense pains, mostly in my arms and legs, that come and go multiple times a day. ..... My problem with the diagnosis is I do not have any muscle-type pain or tenderness which a lot of you describe. Is it possible to have fibromyalgia without any tenderness?
Hi passowac - May I ask back what you then mean by "very intense pains", if not muscles, not painful to touch or pressure?
 

passowac

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I don't know how to describe it, my best guess is it's neuropathic pain. No weakness or tenderness, just really strong stabbing-like pains that come on suddenly, last just a few seconds, then goes away again.
 

Forgetmenot

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That sounds like nerve pain to me.I get that a lot on my feet .and my hands
 

sunkacola

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I don't know how to describe it, my best guess is it's neuropathic pain. No weakness or tenderness, just really strong stabbing-like pains that come on suddenly, last just a few seconds, then goes away again.
I agree with Forgetmenot - that sounds like nerve pain to me. Does it happen in your joints? Or in places like, say, your thighs or claves?
 

passowac

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The fronts of my thighs and my shins, not usually in my calves
 

JayCS

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I get stabs like that too and have heard of it from quite a few others. Now I've got overall pains down what I do is twist-stretch my legs (& if necessary arms) for about 10-30 seconds. Not sure if that'd helped me if everything else was flaring, but then in your case it isn't. Does that help in any way by any chance? (The quickest way for maximum stretching is twisting one foot against the other, heel to toe, one foot in front, then the other. Then inwards, toe to toe, heels outside. If necessary repeat 3-4x. Does that help? or make it worse?)
 
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