Fibromyalgia Tender Points

1. Low cervical-anterior aspects of the intertransverse spaces at C5-C7
2. Second rib-upper lateral to the second costochondral junction
3. Lateral epicondyle-2 cm distal to the epicondyles.
4. Knee-at the medial fat pad proximal to the joint line.
5. Occiput-suboccipital muscle insertions.
6. Trapezius-midpoint of the upper border
7. Supraspinatus-at origins, above the scapula spine near the medial border.
8. Gluteal-in upper outer quadrants of buttocks in anterior fold of muscle.
9. Greater trochanter-posterior to the trochanteric prominence.

Digital palpation performed with 4 kg force causing pain in 11 of 18 points indicates Fibromyalgia.