Few topics in rheumatology have generated as much controversy over the last 50 years as fibromyalgia. It is a very common symptom complex of wide variation and reportedly affects up to five percent of the female population. It is characterized mainly by widespread, often “total body” pain.

Patients often seek out healthcare providers when it comes to musculoskeletal pain. Unfortunately, diagnosing and treating this pain may be complicated by comorbid conditions. Accordingly, we need to examine our comprehensive approach to patients who have arthritis and associated comorbidities. We also need to understand the impact of chronic pain and illness, and the implications for patients and their families.

Fibromyalgia (Fibromyalgia) is a common, costly and sometimes highly debilitating chronic illness. Fibromyalgia affects an estimated 11 million people in the United States and 80 to 90 percent are women. Researchers are now proposing that fibromyalgia be classified as a disease rather than a syndrome because the primary symptom of pain is no longer serving its physiologic purpose.

Soft tissue rheumatism is a collection of nonarticular pain generators that result from pathology of extraarticular and extraosseous periarticular structures. These soft tissue structures include bursae, tendons and their synovial sheaths, entheses, muscles and fasciae. The focal point to soft tissue rheumatism is that pain is not due to pathology of structures within the true joint (i.e., arthritis). Soft tissue rheumatism may manifest itself as well defined pathology of a single periarticular site or a regional myofascial pain syndrome.