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What Is It?

Fibromyalgia is a chronic disorder characterized by widespread pain and reduced pressure pain threshold.

Fibromyalgia is a chronic disorder characterized by widespread pain and reduced pressure pain threshold (tender points). People with fibromyalgia may also experience fatigue, sleep disturbances, stiffness, deep tenderness, soreness and achiness, increased headaches or facial pain, difficulty concentrating, forgetfulness and problems multitasking. Patients with fibromyalgia frequently report functional impairment and diminished quality of life.

The cause of fibromyalgia is unknown, but recent evidence suggests it is associated with abnormalities in the central nervous system processing of pain. Fibromyalgia patients develop an increased response to painful stimuli and experience pain from non-painful stimuli such as touch. This is thought to reflect enhanced pain processing that is characteristic of central pain sensitization.

Patients with fibromyalgia have been found to have elevated levels of substance P in their spinal fluid, a chemical that helps transmit pain signals from the brain. Fibromyalgia patients also have been found to have reduced spinal fluid levels of neurotransmitters such as norepinephrine and serotonin that are involved in the pain inhibitory pathways in the central nervous system. Scientists are investigating how the brain and spinal cord process pain and how substance P and other neurotransmitters fit into the process.

Recent studies have found that fibromyalgia runs in families, suggesting a genetic predisposition to the disorder.

Diagnosing fibromyalgia has been controversial because there are no specific laboratory tests to identify the disorder. Until recently, many health care professionals thought fibromyalgia was primarily caused by psychological factors. In recent years, however, health care professionals have come to understand that psychological factors do not necessarily cause fibromyalgia but rather may contribute to an increased risk for disability associated with fibromyalgia. Furthermore, depression and anxiety disorders may share some of the same chemical imbalances that are associated with fibromyalgia. For example, low levels of certain chemicals in the brain, including serotonin and norepinephrine, are linked not only to depression, but also to pain and fatigue.

It is estimated that at least 2 percent of the U.S. adult population has fibromyalgia. This condition occurs more commonly in women of childbearing age (as many as 80 to 90 percent of those diagnosed with fibromyalgia are women), but children, postmenopausal women, the elderly and men can also be affected. Because diagnosis can be difficult, it may take several years to correctly diagnose. Fortunately, with increased awareness of the disorder, many patients are getting diagnosed earlier than in the past, which may improve long-term outcomes.

The severity of fibromyalgia symptoms varies. For some women, pain or other symptoms can be so intense that they interfere with daily activities. For others, symptoms may cause discomfort but are not incapacitating. However, fibromyalgia can be quite disabling. Many people with the condition report that it interferes with their lives at home and work and gets in the way of their personal relationships. Plus, dealing with a disorder that is so often misunderstood can be extremely frustrating.

Treating fibromyalgia requires a comprehensive approach, encompassing symptom management and lifestyle adaptation. It also requires a team approach with the patient and health care professionals, including physicians, physical therapists and cognitive therapists.


Fibromyalgia is defined by the American College of Rheumatology as chronic (three months or more) widespread pain and pain on palpation of 11 of 18 tender points. Common associated symptoms include sleep problems, fatigue, cognitive impairment and mood disturbances. Even though it is recognized as a legitimate clinical entity, experts think it continues to be underdiagnosed or misdiagnosed.

If you suspect you may have this condition, discuss your symptoms with your primary care physician. Your primary physician may refer you to other medical professionals for further evaluation. For example, you may be referred to a rheumatologist, who specializes in disorders affecting the joints, muscles, tendons, ligaments and bones.

Even with the right doctor, fibromyalgia can be difficult to diagnose. Many of its symptoms are variable, so they're not always there, and many are common across numerous medical conditions. There is no specific medical test for fibromyalgia.

The American College of Rheumatology criteria for fibromyalgia require that a person has had widespread pain above and below the waist, on both sides of the body and in the axial skeleton, for at least three months, as well as pain on palpation of at least 11 of 18 specific tender point sites. You can view an illustration of common tender points in fibromyalgia at

These criteria were designed to standardize classification for participants in clinical trials, and some health care providers find them difficult to understand and use. The American College of Rheumatology has also developed preliminary diagnostic criteria for diagnosing fibromyalgia that do not require tender point exams. Instead, these criteria involve using combined numerical scores that reflect severity of pain and other symptoms. These criteria may include a combination of chronic, widespread pain and other commonly associated symptoms such as fatigue and sleep disturbance.

Your health care provider will diagnose you based on your symptoms, a complete medical history, physical exam and tests to rule out other conditions such as lupus, rheumatoid arthritis or hypothyroidism.

In addition to the pain, sleep problems and fatigue are common in patients with fibromyalgia. Other associated symptoms may include the following:

* Cognitive disorders, most often short-term memory lapses and difficulty concentrating

* Unusual sensitivity to cold, especially in the hands and feet, often accompanied by color changes, numbness and tingling; this condition is known as Raynaud's phenomenon (also called Raynaud's syndrome)

* Urinary complaints, including a strong urge to urinate, frequent urination and pain in the bladder

* Painful menstrual periods

* Heightened sensitivity to noises, bright lights, odors and touch

* Painful sexual intercourse

* Stiffness, particularly in the early morning, after prolonged sitting or standing, or with changes in temperature or relative humidity

* Light-headedness and/or balance problems.

* Abdominal discomfort

* Paresthesia (numbness or tingling), often in the hands or feet

Fibromyalgia also may coexist with other chronic painful conditions such as osteoarthritis, rheumatoid arthritis or low back pain. It frequently is accompanied by central sensitivity syndromes, including irritable bowel syndrome, interstitial cystitis, restless leg syndrome, temporomandibular disorder (TMD), tension-type headaches or migraines, chronic pelvic pain, endometriosis and chronic prostatitis. There also appears to be a link between fibromyalgia and chronic fatigue syndrome (CFS). Up to 70 percent of people with fibromyalgia fit the criteria for CFS.

Fibromyalgia can affect mood and cause psychological distress, and research has shown that a lifetime history of mood or anxiety disorders is common in people with fibromyalgia. When depression or anxiety is present, treatment is important because they can make fibromyalgia symptoms worse and can interfere with successful management. Even if you don't have depression, antidepressants may be prescribed for pain relief and to help you sleep.

Recent studies suggest that depression and fibromyalgia may share a biological link. Low levels of certain chemicals in the brain, including serotonin and norepinephrine, are associated not only with depression, but also with pain and fatigue. Still, not everyone with fibromyalgia will experience depression or anxiety. Up to 74 percent of people with fibromyalgia experience depression and an estimated 60 percent experience anxiety at some point in their lives.


Treating fibromyalgia requires a comprehensive, multidisciplinary approach. Among the most effective treatments are medications, exercise, sleep management and cognitive behavioral therapy.

Treatment centers on managing the symptoms of fibromyalgia; there is no cure. Since symptoms vary, so does treatment.


Exercise may seem an impossibly tall order--after all, if you're in pain, how can you work out? But if you don't get regular aerobic exercise, your muscles become weaker, making them even more susceptible to pain during everyday tasks. In fact, studies find that aerobic exercise such as swimming and walking improves muscle fitness and reduces muscle pain and tenderness in people with fibromyalgia. Stick with a low-impact exercise program such as walking, swimming or water aerobics, and be sure to discuss any new exercise program with your health care professional if you've been inactive.

Exercise can also help you sleep better, improve your mood, reduce pain, increase flexibility, improve blood flow, help you manage your weight and promote general physical fitness. It is inexpensive and, if done correctly, has few negative side effects.

When you exercise, listen to your body and know when to stop or slow down to prevent pain caused by over-exercising. Talk to your health care professional about how to introduce exercise into your life in a way that is tolerable and safe. In some situations, your health care professional may recommend physical therapy with therapists knowledgeable in fibromyalgia management, who can help you with a physical rehabilitation program.

Attitude Can Improve Symptoms

Your psychological outlook is important, with studies finding benefits from cognitive therapy for women with fibromyalgia. Specifically, studies find, negative thinking increases stress and affects your perception of pain, so learning to minimize and control these thoughts can improve your symptoms.

The key is not so much to "think positively," but to "think non-negatively." So when negative thoughts occur, ask yourself: "Does this thought benefit me in any way--does it improve the way I feel, advance my goals or improve a relationship?"

Strategies for dealing with negative thoughts include:

* Alternative interpretation. You might start with a fairly neutral thought such as "I'm tired today." From there, it's easy to go negative--"I feel lousy. I won't get anything done today." An alternative, non-negative interpretation could be: "What strategies can I try to sleep better so I won't feel so tired?"

* Anti-catastrophic reappraisal. This technique consists of challenging negative thoughts. You might have a catastrophic thought such as, "This fatigue is never going to get better. I'll never wake up with any energy." When you have such thoughts, ask yourself: How likely is it really that the fatigue will never get better? Have you ever been more fatigued than you are today?

* Coping statements. In these statements, you tell yourself that you can handle these symptoms, and remind yourself of strategies you've used in the past to cope with or alleviate symptoms.

* Label shifting. How we describe things influences our overall mood and physical sense of well-being. So instead of viewing your pain as excruciating, try describing it as uncomfortable, or view it as a warning that maybe you've been overdoing it.


Pregabalin (Lyrica), previously approved by the U.S. Food and Drug Administration for adjunctive treatment of partial onset seizures and certain types of neuropathic pain, was the first medication to be approved for treating fibromyalgia. Common side effects may include dizziness, sleepiness, dry mouth, swelling, blurred vision, weight gain and difficulty with concentration and attention.

Duloxetine (Cymbalta), previously approved for the treatment of major depression, generalized anxiety disorder and diabetic peripheral neuropathic pain, is also approved for treating fibromyalgia and for treatment of chronic musculoskeletal pain due to chronic osteoarthritis pain and chronic low back pain. Common side effects of duloxetine may include nausea, dry mouth, constipation, sleepiness, increased sweating and decreased appetite. And the third medication approved for the treatment of fibromyalgia is milnacipran (Savella). Common side effects of milnacipran may include nausea, constipation, hot flush, increased sweating, vomiting, palpitations, increased heart rate, dry mouth and hypertension.

Other medications that have medical evidence to support their use in fibromyalgia but are not currently indicated for the treatment of fibromyalgia include the following:

* Antidepressants, including the tricyclic antidepressant amitriptyline (Elavil) and the selective serotonin reuptake inhibitor fluoxetine (Prozac).

* Tramadol (Ultram), a centrally acting analgesic for pain relief, which may be taken with or without acetaminophen.

* Muscle relaxant, cyclobenzaprine (Flexeril), to improve sleep and reduce pain and muscle spasms.

* Anticonvulsant, gabapentin (Neurontin), which is similar to pregabalin (Lyrica).

Complementary Approaches

In addition to medication, a variety of alternative and lifestyle approaches can help you deal with symptoms of pain. However, be aware that there is limited scientific evidence to support these approaches at this time.

* Massage therapy can be very effective short-term. For the best results, look for a licensed massage therapist who has worked with fibromyalgia patients before.

* Moist heat supplied by warm towels, hot packs, a hot bath or a shower can be used at home for 15 to 20 minutes three times a day to relieve symptoms.

* Cold supplied by a bag of ice or frozen vegetables wrapped in a towel helps reduce pain when used for 10 to 15 minutes at a time. Don't do this, however, if you have Raynaud's phenomenon.

* Hydrotherapy (water therapy) can reduce pain during exercise and help you improve endurance and conditioning. Exercising in a large pool may be easier because water has a buoying effect. Community centers, YMCAs and YWCAs have water exercise classes developed for people with arthritis and other conditions that may make exercise painful. To find a YMCA or YWCA in your area, check out Some patients also find relief from the heat and movement provided by a whirlpool.

* Relaxation techniques help reduce pain and anxiety. These include meditation and guided imagery. Check with local recreation centers and hospitals for courses.

* Acupuncture is an ancient Chinese treatment that is often used for pain relief. A qualified acupuncturist places very thin needles in certain parts of your body. Some researchers believe that the needles may stimulate deep sensory nerves that tell the brain to release natural painkillers (endorphins). However, the well-controlled studies examining acupuncture as a treatment for fibromyalgia symptoms did not find acupuncture to be more effective than a placebo treatment for fibromyalgia, so it is difficult to know for sure if the practice produces any specific benefits. Acupressure is similar to acupuncture, but pressure is applied to the sites instead of needles.

* Biofeedback is a form of therapy used to train your mind to understand and, to a degree, control your own physiological responses. An electronic device provides information about a body function (such as heart rate) so you learn to consciously control that function. For instance, it can help you learn to relax your muscles.


There is no known way to prevent fibromyalgia. Instead, the most important thing is to find a way to manage it and to find a health care team to help you.

Once diagnosed, you should monitor your pain, noting activities that increase it and therapeutic approaches that reduce it. Repetitive activities may temporarily make things worse, such as sitting in one position for a long time. Pain can also flare when doing chores like cleaning, typing or driving for hours with your arms in the same tensed position. Even reading in a slumped position may trigger pain.

The key is to make adjustments--change positions, take a quick break or give your back, arms or neck more support--before the pain worsens. You can also make adjustments to your cleaning routine, using lighter appliances to minimize muscular distress.

Obviously, fibromyalgia can interfere with work, especially if your job involves a repetitive physical task, heavy lifting or working outdoors when it's cold. Research finds that fibromyalgia patients tend to do better if they work, however, so if the disease is affecting your ability to work, talk to your health care professional about how you can reduce the strain.

Most important is to improve your physical conditioning and endurance, find ways to manage and reduce stress and maintain a regular schedule.

Facts to Know

1. Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain and multiple tender points. "Tender points" refers to tenderness that occurs in localized areas, particularly in the neck, spine, shoulders and hips.

2. People with fibromyalgia may also experience fatigue, sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, depression and other symptoms.

3. At least 2 percent of the U.S. adult population suffers from fibromyalgia, and it predominantly affects women. The condition primarily occurs in women in early and middle adulthood, but children, the elderly and men can be affected.

4. There is no cure for fibromyalgia, though the disorder can be successfully managed.

5. Fibromyalgia is defined based on widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites for at least three months. There are no lab tests to confirm a diagnosis, although some tests may be used to rule out other conditions with similar symptoms, such as rheumatoid arthritis or lupus.

6. There appears to be a link between fibromyalgia and chronic fatigue syndrome (CFS). Up to 70 percent of people with fibromyalgia fit the criteria for CFS.

7. Low-impact aerobic exercise such as walking and swimming can help manage the symptoms of fibromyalgia. Physical therapy and stretching exercises also help.

8. A variety of medications are used to treat fibromyalgia, including the three FDA-approved medications for fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella). Additional medications include other antidepressants and anti-seizure drugs.

9. If you are diagnosed with fibromyalgia, you should monitor your pain, noting activities that increase it and therapeutic approaches that improve it. Repetitive activities may temporarily exacerbate the condition, as may sitting in one position for a long time.

10. Studies find that negative thinking increases stress and affects your perception of pain, so learning to minimize and control these thoughts can improve your symptoms. The key is not so much to "think positively," but to "think non- negatively."

Questions to Ask

Review the following Questions to Ask about fibromyalgia so you're prepared to discuss this important health issue with your health care professional.

1. Do my symptoms suggest fibromyalgia?

2. Do you have experience diagnosing fibromyalgia and similar diseases? If not, can you refer me to someone who does?

3. Could medications help me?

4. What are the side effects and potential drug interactions of medications prescribed for me?

5. Are there fibromyalgia support groups in this area?

6. Can you help me plan a personal program for my fibromyalgia that includes exercise, sleep and lifestyle changes?

7. What should I do if my pain or any other symptom gets worse?

8. How might fibromyalgia interact with other health conditions I have?

9. What are some strategies I can use to get through the day at work when I'm in pain?

10. What changes should I make in the way I manage the disease if I decide to get pregnant?

Key Q&A

1. What are the symptoms of fibromyalgia?

The classic symptoms of fibromyalgia are widespread pain, tenderness, fatigue and problems sleeping. Other symptoms include (but are not limited to) cognitive dysfunction, stiffness, irritable bowel syndrome, depression and anxiety.

2. What causes the disease?

No one knows exactly what causes fibromyalgia, but current thinking centers on a theory called "central sensitization," which means that people with fibromyalgia have increased sensitivity to pain signals in their brains, resulting in a lower threshold for pain. Women make up 80 to 90 percent of people with fibromyalgia. The most common time for women to develop the condition is in early and middle adulthood.

3. I think I may have fibromyalgia, but my doctor doesn't know much about the disease. What should I do?

Ask for a referral to a rheumatologist or physiatrist who is knowledgeable about the disease. A rheumatologist is a doctor who specializes in disorders that affect the joints, muscles, tendons, ligaments and bones. A physiatrist specializes in diagnosing and treating injuries and diseases causing pain, loss of function and disability.

4. I have heard that aerobic exercise is good for fibromyalgia, but how can I possibly exercise when I'm in such pain?

If you've been sedentary for a while, you should start out with stretching exercises for several weeks. Therapy in warm water is easier than therapy on land. Heat, massage, hydrotherapy (exercising in a pool or using a whirlpool) and relaxation therapy are among the strategies that may help. Discuss any exercise plan with a health care professional before you start. A physical therapist knowledgeable in fibromyalgia may also help you develop a physical activity program.

5. What medications are available to treat fibromyalgia pain?

The U.S. Food and Drug Administration has approved three drugs for the treatment of fibromyalgia symptoms: pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella). Other medications commonly used include other antidepressants and anti-seizure drugs.

6. What medications are available to treat the sleeping problems associated with fibromyalgia?

Some sedating antidepressants are sometimes effective, and occasionally a doctor may prescribe a short-term course of sleeping pills. A muscle relaxant called cyclobenzaprine (Flexeril) may temporarily help to improve sleep and reduce pain. Pregabalin (Lyrica) and gabapentin (Neurontin) have been shown to improve sleep in patients with fibromyalgia. If you're having trouble sleeping, you may also want to employ standard nonmedical remedies and good sleep hygiene, such as avoiding caffeine, forgoing naps, avoiding alcohol and going to bed at the same time every night. A sleep specialist may help to identify and treat other sleep disorders such as sleep apnea that can occur in some patients with fibromyalgia.

7. What is the relationship between fibromyalgia and depression?

It is estimated that up to 74 percent of those with fibromyalgia experience depression and about 60 percent experience anxiety at some point in their lives. What causes the correlation between fibromyalgia and depression is unclear, but it may be related to low levels of certain brain chemicals, including serotonin and norepinephrine.

8. Why has the diagnosis of fibromyalgia been so controversial?

Because up until the late 1990s, no pathological origin for the chronic, persistent pain could be found. Now multiple studies link the condition to abnormal pain processing in the central nervous system. Because women who presented with the syndrome often had depression and anxiety along with their condition, some doctors thought fibromyalgia was primarily caused by psychological factors. In recent years, skepticism has largely given way to interest in more fully characterizing symptoms and finding effective treatments.

9. What are some nonmedical approaches to treating the disease?

Medications may be necessary, but there are a number of day-to-day strategies for coping with the disease. A fibromyalgia support group can help provide insight, advice and support. You can improve sleep by avoiding naps and caffeine and by going to bed at a consistent time. You should also monitor your pain and adjust your activities accordingly. To manage pain, you can try massage, heat and cold packs, relaxation therapy, water therapy (such as whirlpools), biofeedback and acupuncture or acupressure.

Organizations and Support

For information and support on coping with Fibromyalgia, please see the recommended organizations, books and Spanish- language resources listed below.

American Chronic Pain Association


Address: P.O. Box 850

Rocklin, CA 95677

Hotline: 1-800-533-3231


American College of Rheumatology


Address: 1800 Century Place, Suite 250

Atlanta, GA 30345

Phone: 404-633-3777

American Occupational Therapy Association


Address: 4720 Montgomery Lane

P.O. Box 31220

Bethesda, MD 20824

Hotline: 1-800-377-8555

Phone: 301-652-2682

American Pain Society


Address: 4700 West Lake Ave.

Glenview, IL 60025

Phone: 847-375-4715


Fibromyalgia Network


Address: P.O. Box 31750

Tucson, AZ 85751

Hotline: 1-800-853-2929

Phone: 520-290-5508


Integrative Medicine Resource for Fibromyalgia


Address: 2522 North Lincoln Avenue

Chicago, IL 60614

Phone: 773-296-6700


International Association for Chronic Fatigue Syndrome


Address: 27 N. Wacker Drive, Suite 416

Chicago, IL 60606

Phone: 847-258-7248


National Fibromyalgia Association


Address: 2121 S. Towne Centre Place, Suite 300

Anaheim, CA 92806

Phone: 714-921-0150


National Fibromyalgia Partnership (NFP)


Address: P.O. Box 160

Linden, VA 22642

Hotline: 1-866-725-4404

National Fibromyalgia Research Association


Address: P.O. Box 500

Salem, OR 97308

Phone: 503-315-7257


National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)


Address: National Institutes of Health

Bldg. 31, Room 4C02 31 Center Dr.--MSC 2350

Bethesda, MD 20892

Hotline: 1-877-22-NIAMS (1-877-226-4267)

Phone: (301) 496-8190


Alternative Medicine Guide to Chronic Fatigue, Fibromyalgia & Environmental Illness

by Burton Goldberg

Fibromyalgia Advocate: Getting the Support You Need to Cope with Fibromyalgia and Myofascial Pain Syndrome

by Devin Starlanyl

Fibromyalgia & Chronic Myofascial Pain Syndrome: A Survival Manual

by Devin J. Starlanyl, Mary Ellen Copeland

Fibromyalgia Handbook

by Debra Fulghum

Fibromyalgia Relief Book: 213 Ideas for Improving Your Quality of Life

by Miryam E. Williamson, Mary Anne Saathoff

Making Sense of Fibromyalgia: A Guide for Patients and Their Families

by Daniel J. and Janice Brock Wallace

Medline Plus: Fibromyalgia


Address: Customer Service

8600 Rockville Pike

Bethesda, MD 20894


American College of Physicians: Health Tips Fibromyalgia


Address: ACP Foundation

190 N. Independence Mall West (corner of 6th and Race Streets)

Philadelphia, PA 19106

Hotline: 1-877-208-4189


American Academy of Family Physicians, Family Doctor: Fibromyalgia


Email: (on-line contact form)

Arnold LM, Clauw DJ, McCarberg BH for the Fibrocollaborative. Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 2011;86:457-464.

Clauw DJ, Arnold LM, McCarberg BH, for the FibroCollaborative. The science of fibromyalgia. Mayo Clin Proc 2011;86:907- 911.

Arnold LM, Clauw DJ, Dunegan LJ, Turk DC, for the FibroCollaborative. A framework for fibromyalgia management for primary care providers. Mayo Clin Proc 2012;87:488-496.

"Patient information: Fibromyalgia." Updated June 2012. beyond-the-basics. Accessed June 2012.

Williams DA, Clauw DJ. "Understanding fibromyalgia: lessons learned from the broader pain community." J of Pain. 2009;8:777-791.

Ablin K, Clauw DJ. "From fibrositis to functional somatic syndromes to a bell-shaped curve of pain and sensory sensitivity: evolution of a clinical construct." Rheum Dis Clin Am. 2009;35:233-251.

National Pain Foundation. Available at: Accessed October 6, 2009.

Wolfe F, Clauw D, Fitzcharles MA, Goldenberg DL, Harp KA, Katz RS, Mease PJ, Michaud KD, Russell AS, Russell IJ, Winfield JB, Yunus MB. "Clinical diagnostic and severity criteria for fibromyalgia." Presented at: American College of Rheumatology Scientific Meeting, Philadelphia, October 16-21, 2009.

Thieme K, Turk D, Flo H. "Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables." Psychom Med. 2004;66:837-844.

"Q&A Fibromyalgia." The National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institutes of Health. April 2009. Accessed December 2009.

"Fibromyalgia." Medline. The National Institutes of Health. February 2009. Accessed December 2009.

"Fibromyalgia." The Mayo Clinic. January 2009. Accessed December 2009.

"Fibromyalgia." The Mayo Clinic. Updated June 2007. Accessed July 2007.

"Fibromyalgia." The American College of Rheumatology. Accessed July 2007.

"Fibromyalgia: What it is and how to manage it." Accessed July 2007.

"The 2006 Annual Fibromyalgia and Fatigue Survey." Fibromyalgia and Fatigue Centers, Inc.

"Fibromyalgia." U.S. News and World Report from a white paper published by Johns Hopkins.

"FDA Issues Public Health Advisory on Vioxx as its Manufacturer Voluntarily Withdraws Its Product." U.S. Food and Drug Administration. Accessed October 1, 2004.

"About Fibromyalgia: What Causes Fibromyalgia?" National Fibromyalgia Association. Accessed June 11, 2004.

"About Fibromyalgia: How is Fibromyalgia Treated?" National Fibromyalgia Association. Accessed June 11, 2004.

Clinical Trials in Fibromyalgia. National Library of Medicine. Accessed June 11, 2004.

Fibromyalgia." The National Women's Health Information Center. Accessed June 11, 2004.

"Questions and Answers About Fibromyalgia." National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published Dec. 1999. Accessed June 11, 2004.

Cote, K. Harvey M. "Sleep, Daytime Symptoms and Cognitive Performance in Patients with Fibromyalgia. Journal of Rheumatology. 1997: 24:2014-23.

Moldofsky, H. "Fibromyalgia: An Enigmatic Illness and Its Management." Canadian Journal of Diagnosis. Oct. 1999. 73-80.

Pimentel, M. Hallegua, D. Lin, HC. et al. "Improvement in Fibromyalgia with Treatment of Small Intestinal Bacterial Overgrowth (SIBO): A Double Blind Randomized Study."Arthritis & Rheumatism. 42:S343, 1999. Accessed June 11, 2004.

Small Intestinal Bacterial Overgrowth in Fibromyalgia. FibroFree Fibromyalgia Recovery Program. Accessed June 11, 2004.

Yunus, M. "Fibromyalgia and overlapping syndromes." Fibromyalgia Network. Accessed June 11, 2004.

Chang, L. "The Association of Functional Gastrointestinal Disorders and Fibromyalgia." European Journal of Surgery; 1998; Supplement 583: 32-36.

Fibromyalgia and Chronic Myofascial Pain. Excerpted from "Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Guide" by DJ Starlanyl and ME Copeland. Revised April 7, 2004. Accessed June 11, 2004.

Burckhardt C. "How Pain Affects the Mind." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99- 5/21/00. Universal City, Calif.

Jasmin L. "FMS: A CNS Disease." Fibromyalgia Network (newsletter). April 21, 2000.

Engstrom D. "Biofeedback" Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Engstom D. "Coping with Emotions: The Role of the Psychologist/Psychiatrist." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Moldofsky H. "Sleep, neuroimmune and neuroendocrine functions in fibromyalgia and chronic fatigue syndrome." Advances in Neruoimmunology. Vol. 5. 1995. 39-56.

Pillemer S, Bradley L, Crofford L, et al. "The Neuroscience and Endocrinology of Fibromyalgia." Arthritis & Rheumatism. Nov. 1997. Vol. 40, No. 11. 1928-1939.

Bennett R. "Chronic Widespread Pain and the Fibromyalgia Construct." Pain Digest. 1999. 9:292-298.

Russell J. "Fibromyalgia Syndrome." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Wallace D, Linker-Israeli M, Hallegua D, et al. "Cytokines play an etiopathogenetic role in fibromyalgia: A pilot study." Abstract 950156. Presented at the American College of Rheumatology, 64th Annual Scientific Meeting, April 30, 2000.

Hardy M. "Fibromyalgia and Integrative Medicine: Evaluation of Efficacy & Safety." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

"What Research Is Being Conducted on Fibromyalgia?" National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published Dec. 1999. Accessed June 11, 2004.

"FM Monograph" National Fibromyalgia Partnership, Inc. Copyright 2004. Accessed June 11, 2004.

"Fibromyalgia Medicationst" The Arthritis Foundation. 2004. Accessed June 11, 2004.

Arnold LM. "Biology and therapy of fibromyalgia. New therapies in fibromyalgia." Arthritis Research and Therapy 2006;8:212.

Arnold LM, Hudson JI, Hess EV, et al. "Family study of fibromyalgia." Arthritis and Rheumatism 2004;50:944-952.

Arnold LM, Hudson JI, Keck PE, et al. Comorbidity of fibromyalgia and psychiatric disorders. J Clin Psychiatry 2006;67:1219-1225.
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