These vary, with long-standing pain over much of the body, fatigue, poor sleep and depression generally prominent, sometimes causing considerable disability. Headache, urinary frequency and abdominal symptoms are also common.

Few objective signs are found on examination, except that there are often multiple hypersensitive tender points (e.g. low cervical spine, low lumbar spine, suboccipital muscle, mid upper trapezius, tennis-elbow sites, upper outer quadrants of buttocks, medial fat pad of knees). In coming to a diagnosis, practitioners will first exclude other conditions with similar symptoms, such as inflammatory arthriti, inflammatory arthritis, hypothyroidism (see THYROID GLAND, DISEASES OF), SYSTEMIC LUPUS ERYTHEMATOSUS and inflammatory myopathy (see MUSCLES, DISORDERS OF). There is no blood or radiological test for the condition.

This is not known although research shows that for a standard level of pain stimulus, persons with fibromyalgia report more severe pain than control subjects.

Physiotherapy and psychological therapies such as COGNITIVE BEHAVIOUR THERAPY (CBT) may be recommended to help patients cope with the condition and any associated depression. There is only very limited evidence from clinical trials as to the value of drugs: however, some patients are helped by simple analgesics, such as paracetamol and NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) or by opioids such as Tramadol. There is some evidence that antidepressants help some and others claim they are assisted by the anticonvulsants, pregabalin and gabapentin (although they are not licensed in the UK for treatment of fibromyalgia).