Fibromyalgia is a chronic disorder characterized by widespread pain that is often accompanied by fatigue, depression, sleep disturbance, cognitive impairment, and digestive and urinary symptoms. Current theories suggest that fibromyalgia may be caused by irregular activity within the central nervous system This is because the pain it causes does not seem to be a result of physical or mechanical problems in the body (e.g. a broken bone, a pulled muscle, inflammation) but instead, seems to be caused by the brain's management of pain signals.
The condition should be considered as a diagnostic possibility in all cases of persistent, significant musculoskeletal pain, fatigue diet for prediabetes or sleep disturbance, particularly when such symptoms seem out of proportion to the severity of any background chronic illness.

Management of fibromyalgia begins with a detailed history and a thorough physical and laboratory examination (see Presentation and Workup ). Making a correct diagnosis is crucial, and patients need to know that a name exists for the mysterious symptoms that they are experiencing.
If a patient has joint symptoms, an internist could also check rheumatoid factor and anti-cyclic citrullinated peptide antibody, and if a patient reports weakness (which is not particularly characteristic of fibromyalgia), internists could also check creatine phosphokinase, she said.

The biochemical changes seen in the CNS, the low levels of serotonin, the four-fold increase in nerve growth factor, and the elevated levels of substance P all lead to a whole-body hypersensitivity to pain and suggest that fibromyalgia may be a condition of central sensitization or of abnormal central processing of nociceptive pain input.
Despite being one of the most common chronic pain conditions, fibromyalgia remains one of the most difficult to diagnose, due in part to the loose confederation of nonspecific symptoms associated with this condition, including fatigue, musculoskeletal pain and insomnia.
They can include fatigue, post-exertional malaise, sleep problems, cognitive problems (e.g fibrofog” - difficulty concentrating, poor short-term memory, slowed information processing, problems multi-tasking) muscle spasms, rashes, problems standing, irritable bowel symptoms, muscle weakness, myoclonic twitches, pelvic pain, poor coordination and hypoglycemia.

The authors argue that misdiagnosis is driven more by socially-constructed factors” like pharmaceutical companies aggressively teaching doctors to diagnose fibromyalgia and prescribe (unproven) drugs for it; patient advocacy groups trying to legitimize the diagnosis; and doctors seeking prestige by publishing about fibromyalgia.
In a study published in Arthritis Research & Therapy, Claudia M. Campbell, PhD, associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine, and colleagues investigated 57 patients with fibromyalgia who completed catastrophizing, depression and pain questionnaires along with a cold pressor pain assessment at baseline, post-intervention and at 3 months of follow-up.

The diagnosis of fibromyalgia is especially suspected in people who hurt all over” or always feel as if they have the flu.” A diagnosis for fibromyalgia is ultimately made by examining the patient for specific tender points on the body, and noting whether the patient has fatigue, non-restorative sleep, difficulty concentrating, and the presence of some of the coexisting and overlapping symptoms or disorders listed above.
In a recent study published in the journal Arthritis Care & Research , researchers discovered that doctors at a university rheumatology clinic over-diagnosed fibromyalgia in 43 patients out of 121 who met the criteria, and missed it entirely in 60 patients.
The current epidemic of fibromyalgia, chronic fatigue syndrome, sick building syndrome, and multiple chemical sensitivity syndrome is arguably due, at least in part, to media hype, fear, suggestibility, and a focus on definable causes by patients and physicians.