Fibromyalgia is a condition characterized by painful muscles in multiple parts of the
body, fatigue, difficulty sleeping, depression and other symptoms. This condition has
been studied for years, and the medical establishment which previously denied its existence
is now coming to terms with its features. For many years, physicians derided patients with
this condition as depressed ladies that didn’t want to work. It typically affects females more
than men, and can linger for years without a common cause. Over most of the past ten years,
rheumatologists have taken the lead in treating and diagnosing this condition. Standard
diagnostic criteria now exist that are accepted by those treating this problem. This may

develop spontaneously, or after an injury. 18 trigger points are testing from the head and shoulders, to back, knees and hips. If more than 11 are sufficiently tender, the condition has been present for at least six months, and several other features are present, a diagnosis can be made. Lupus, rheumatoid arthritis, and several other immune based diseases are typically excluded by examination and blood test results.

Standard treatment has consisted of nonsteroidal anti-inflammatory agents, muscle relaxers, exercise, stretching and physical therapy, often with an antidepressant and sleep aid. Some individuals require chronic narcotic medications for pain control. PET scan studies have shown that those suffering from this disorder have higher levels of arousal which may feed into the insomnia symptoms. Pregabalin (Lyrica) is the first medication that has received FDA approval for fibromyalgia, this is a medication that decreases over excitability in nerves of the brain. Studies are ongoing to determine whether attacking the insomnia directly will affect the pain and other symptoms. With the discovery of central nervous system features of this disease, neurologists have become more involved with diagnosis and treatment in the past few years.