SUMMARY
Fibromyalgia (FM) is a syndrome of widespread pain and fatigue. It typically occurs in young and middle-aged women. The cause of FM is not known. Many theories exist. Some experts think FM is a neurologic disease. Normal sensations are somehow misinterpreted as painful. Other theories have to with an as yet unidentified underlying infectious, psychological or even sleep disorder. Because the cause is not known, FM is considered a syndrome and not a disease. In some ways this is good. It is not associated with a fatal disease like cancer and it is not physically degenerative. But, because there is no cause there is no specific treatment. Treatment is symptomatic.

DIAGNOSIS
There is no test that diagnoses FM conclusively. The diagnosis is considered clinical meaning a doctor makes the diagnosis based on the history and physical alone and not based on lab or x-rays. There are criteria for the diagnosis. This is mainly for research purposes but can be useful to assure a correct diagnosis.

WHAT TREATMENTS?
In surveys of patients with FM, non-drug treatments were much more successful than drug treatments. The interventions with the most success were aerobic exercise, yoga and relaxation techniques. Most patients try prescription medicines in three categories: anti-inflammatory pain medicine, muscle relaxants and anti-depressants.

OUTLOOK
Studies addressing the prognosis of patients diagnosed with FM show three different courses. A third of patients improve, a third stay about the same and a third get worse. Until researchers come up with better understanding of this syndrome, it will remain a frustrating diagnosis for patients and doctors.