Tender Points

I read it somewhere that Dr Sarno said 99% of tms sufferers will have the tender points. I have not had any but today i noticed i have soreness on the sides of the glutes. Just wondering if most other people have the tenderness or not.

 

Yep, I get ‘em. Glutes, for sure.

 

I don't know if almost every TMSer has them (if Sarno said they do, then he saw enough patients in his time to make me think he was probably right) but tender points were once a key diagnostic tool for diagnosing Fibromyalgia Syndrome and I believe Sarno said that 'Fibromyalgia Syndrome' was the worst manifestation of TMS.

I was diagnosed with so called 'Fibromyalgia Syndrome' in 1997 and I have tender points in all of the specific areas that they used to use for diagnosing it (plus, for good measure, tender points elsewhere too). I think tender points are still taken into account, but I understand that they're no longer the primary method for diagnosing Fibromyalgia. While the American College of Rheumatology initially identified 18 specific tender points to assess pain sensitivity, current diagnostic criteria focus on widespread pain, symptom severity, and ruling out other conditions. These tender points were used to assess pain sensitivity in specific areas of the body, and a certain number of positive responses (tenderness to pressure) were previously required for diagnosis. Fibromyalgia though is actually TMS... no doubt (in my mind anyway) that it is.

Of the 18 tender points there are two tender points in the gluteal area, located in the outer quadrants of the buttocks.

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I know Sarno's list was smaller than the original fibro list, I believe the upper traps, lower back, and upper glutes (six total counting both sides). I have at least five of six, my right upper glute isn't really tender.

 

Eh. Sarno was the one who called them out. I don't focus on them, just was aware when I read that part that yep, got those.

 

Yep, as @Rusty Red says, "Sarno was the one who called them out", so I don't believe we deserve the finger-wagging criticism.

My response to the OP's query was to say, yes, I've got them, tender points have been associated with so called 'fibromyalgia syndrome' (with which I was diagnosed by the medical profession, before I knew better) and Sarno said that 'fibromyalgia syndrome' is severe TMS.

For once, we can actually tell people that a particular physical symptom (of tender points) is TMS, because the great man himself observed it to be so. To my mind, that's a good thing, and far from a waste of time to mention and discuss because, as we know only too well, doubt that symptoms are TMS is one of the biggest blocks to people being willing to do 'the work' and recovering.

Obviously, I appreciate that there may be some people who will say, "I don't have tender points, so I'm doubting that my particular symptoms are TMS" but, as we also know, there are other ways that they can endeavour to prove to themselves that their symptoms are actually TMS, and Sarno apparently didn't say that all TMSers have them.

There is also the aspect that Sarno said that he believed TMS pain to be caused by mild oxygen deprivation which has been in recent years debunked by many, so it might be postulated that he was wrong about tender points too, but he did observe them in most of his TMS patients and he saw a lot of patients so, as we don't 'throw everything out with the bath water' on this Wiki and its forums as far as Sarno's work is concerned, this observation is presumably considered valid until it might be proved otherwise.

From Perplexity.ai (for anyone reading this thread who has tender points and is interested)...

"Dr. John Sarno discussed the concept of tender points in his work on Tension Myositis Syndrome (TMS). He described that most TMS patients have tenderness at six key points: two in the upper trapezius muscles (top of both shoulders), two in the lumbar paraspinal muscles (both sides of the small of the back), and two in the lateral upper buttocks (outer aspect of both buttocks). Sarno sometimes referred to these areas as "tender points" or "trigger points," though he did not strictly use those terms. He believed these tender points are a hallmark finding in TMS, often persisting even after pain resolves.

While fibromyalgia diagnosis often relies on the presence of 11 out of 18 tender points, Sarno focused on these six primary points for diagnosing TMS. He suggested that the persistence of tenderness at these sites is a physiological feature of TMS rather than a separate or purely physical disorder.

Dr. John Sarno stated that fibromyalgia is essentially a severe form of Tension Myositis Syndrome (TMS). He considered fibromyalgia to be synonymous with severe TMS and emphasized that patients with fibromyalgia typically have several tender points similar to those used to diagnose TMS. Sarno believed that fibromyalgia symptoms are manifestations of the same mindbody process underlying TMS, involving physical pain caused by unconscious emotional stress and tension rather than structural abnormalities. This perspective implies that fibromyalgia can be treated as a psychosomatic condition like TMS by addressing the psychological origins of the pain."

 

Good advice!

From the Mindbody Prescription about tender points...

"In the prone position the entire back is palpated for what are called tender points. It has been found that in 99 percent of patients with TMS there is pain on palpation of varying degrees on both sides (bilateral) of the lateral upper buttock, deep in the lumbar paraspinal muscles and the upper trapezius muscles (the top of the shoulders). Once more, this is so regardless of the major site of pain. This suggests very strongly that the process responsible for the pain originates in the central nervous system, in the brain.

It is not a coincidence that I have found bilateral tender points on finger pressure at three of the nine locations in 98 percent of all patients diagnosed with TMS, regardless of the location of their pain. For example, the patient may complain of pain in the neck and shoulder on one side but will have pain on pressure over the gluteal and hip bone areas as well as the top of the shoulder. Though not as uniformly consistent as those three, many of my patients also have pain on pressure over the elbow, the knee, the base of the skull and the back of the neck. The painful structures at four of the nine locations—the base of the skull, the hip area, the elbow and the knee— are tendons; involvement of tendons is a prime feature of TMS. I have maintained for years that fibromyalgia was a severe form of TMS. The similarity of my findings to the diagnostic criteria of the American College of Rheumatology reinforces that diagnostic conclusion.

Fibromyalgia produces tender points all over: the front and back of the trunk, the legs and arms. Fibromyalgia patients are stiff, tired and usually anxious, depressed, insomniac.

People with fibromyalgia commonly have psychological symptoms as well. They are often anxious and depressed, have sleep problems and suffer from lack of energy. Since fibromyalgia is part of TMS, I have seen and successfully treated many patients who had been given that diagnosis before they came to me. Most of my cases did not fulfill the diagnostic criteria set forth by the American College of Rheumatology, but were told they had fibromyalgia nevertheless. The female/male incidence ratio of fibromyalgia in the United States is ten to one. There are millions of American women languishing with this diagnosis, for they have been told by their
medical advisers that the cause of fibromyalgia is unknown and that they must learn to live with the pain. One such patient chose assisted suicide recently. Clinicians have asked, Is fibromyalgia a separate entity? Only as part of TMS and, therefore, it is a mindbody process. That, of course, explains why it has remained a diagnostic enigma to doctors."

Reading what Dr Sarno said about tender points - he says about them in all three of his books - was an absolute life saver for me. It helped convince me that what I was experiencing (so called 'fibromyalgia syndrome', widespread severe muscle pain and muscle stiffness) was not an incurable medical condition, it was actually mind/body/TMS. I then started doing mind/body/TMS work and have gone from being bedridden and house bound to functioning really well by comparison, and every day I continue to improve. I hope this inspires someone reading this to do mind/body/TMS work to lose their symptoms and get their life back.

 

Yeah...that was just something else to trip out about while I was recovering. "Wait..do I have these?....let me bend in an impossible position and poke around....wait, Now I'm not sure!...maybe I DON'T have TMS and I am really just f**ked!"

It was just a clinical observation of Sarno's. TBH when I am involved in a TMS episode (been a long minute BTW) I couldn't poke these if I wanted to...and then when it's over? I couldn't care less.

I love the turning point in the Psychology chapters. Summed up as "So, all of this is academic and diagnostic...the REAL Problem is...."
But all of our minds want to keep us locked up in diagnosis, over and over and over.... It is OCD of the body. Checking and rechecking and qualifying and not qualifying and so forth.

My New Avatar is my Son's newest addition. Daisy. Sweetest little Hound dog...and absolutely a puppy terror! The Long ears must be to hide the horns (LOL) I wish I could get a blood transfusion of her energy level! Now that my dog is grown up, I forgot how Crazy she was when she was a pup. My high energy, squirrel killing dog actually tried to HIDE from the puppy because of the whirlwind of energy. My son can't, so he got TMS instead.

He came over the other day after a week of preparing to go on tour, Watching the puppy every minute and pouring foundations for homes in the 95* heat.

He was walking really stiff and said "Oh dad...I am having the Gnarliest TMS attack" Then he rattled off MORE stressful stuff I wasn't aware of. He didn't for a second think there was anything wrong with him. We didn't check his tender points. He doesn't hang out on forums asking "Is this TMS....well, my one doctor says (blank) but my other doctor says (blank) " I taught them about TMS but neglected to bore them with the diagnostic stuff...when you know, you know. And when You don't? You're even better, because you dive right into hunting the problem.

TBH we don't have the money...well we do, but we spend it on guitars and tools and toys and rent and dog food. There's just none left for TMS counselors or Md. visits.

One paperback copy of Sarno and your good. If you've been around? Skip ahead to the psychology chapter and the COMMANDMENTS (suggestions) that Sarno drops. I just assume every suggestion is a commandment and it has served me well for over a quarter century. 11 bucks for my life back was a really good deal!

 

I don’t know if these tender points really contributed to my issues but I know I have them. My pelvic floor physical therapist pressed on the ones on my glutes and I about jumped through the ceiling. Haha. I started laughing like crazy because that’s what I do when I’m uncomfortable physically sometimes (really only when a pt is touching me or I’m getting a tattoo, I’ll giggle). But I believe these are natural consequences to people having anxiety and tensing their bodies up. I don’t believe they are a root cause to why people have pain. Simply a common reaction to having anxiety, if that makes sense.

 

One point of confusion in the TMS talk is the origin of pain, if it's purely made of over sensitivity or if there's a physical component involved. I believe it's truly a mindbody experience and there's both. For example burning and itching sensations in some areas, and muscular spasms in others. Both caused by the danger state brain, meaning either way it's a matter of knowing it's not structural and is treated exposing yourself to the hidden feelings and exercises.

Anyway it always helps to be mindful of the tension in your body, and do relaxation exercises like contract a muscle and then release it.