Fibromyalgia (FM) is a chronic pain disorder that afflicts
predominantly middle-aged women with cardinal symptoms of
diffuse musculoskeletal pain, defined tender points, deprived
sleep, and fatigue. The etiology and pathological mechanisms
are poorly understood, and treatment approaches are largely
ineffective. The clinical features of the syndrome are
presented, and the relevance of muscle dysfunction in the
etiopathogenesis of the disorder is explored. The evidence for
involvement of muscle pathophysiology as a primary mechanism
mediating the onset of symptoms is not compelling.
Musculoskeletal dysfunction can be considered secondary to
central abnormalities of pain modulation and altered sleep
physiology precipitated by emotional stress in genetically
predisposed individuals. Contemporary evidence favors
treatment strategies that emphasize pain control, sleep
enhancement, and a program of conditioning.