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“The term trigger points, which has been around for many years, refers to the pain elicited when pressure is applied over various muscles in the neck, shoulders, back, and buttocks. There is some controversy over what precisely is painful, but most would agree that it is something in the muscle. Rheumatologists, who have taken the lead in studying fibromyalgia (TMS), appear to avoid using the term, probably because of its association with other diagnoses through the years. I neither use it nor avoid it, for I have concluded that these points of tenderness are merely the central zones of oxygen deprivation. Further, there is evidence that some of these points of tenderness may persist for life in TMS-susceptible people, like me, though there may be no pain.

In the first chapter, the point was made that most patients with TMS will have tenderness at six key points: the outer aspect of both buttocks, both sides of the small of the back (lumbar area), and the top of both shoulders. These tender points, trigger points, call them what you will, are the hallmark findings in TMS, and they are the ones that tend to persist after the pain is gone. It is an important part of the physiology of TMS to know that the brain has chosen to implicate these muscles in creating the syndrome we know as TMS.

Patients sometimes ask if breathing pure oxygen will relieve the pain. This has been tried and, unfortunately, does not help. If the brain intends to create a state of oxygen deprivation, it will do so regardless of how oxygen rich the blood is.”