Fibromyalgia is a common cause of diffuse body pain and tenderness of the muscles, chronic fatigue, sleep that does not restore energy, and problems with memory and thinking clearly. It is not a form of arthritis and does not damage the joints or muscles. The diagnosis is based on the presence of these symptoms and is no longer based on the number of tender points. There is no test to detect or prove this disease, but blood and imaging tests can be done to rule out other health problems. There is no cure for fibromyalgia, but patients can feel better with medications and lifestyle choices. Fibromyalgia is associated with depression, anxiety, migraine or chronic tension headaches, irritable bowel syndrome, irritable bladder, pelvic pain such as endometriosis, sleep apnea, multiple sclerosis, spinal stenosis of the neck, or any chronic arthritis disease. Fibromyalgia can run in families but the genetics are unknown and is more common in females. It is usually triggered by chronic pain, stress or lack of sleep. It is thought that the brain becomes hypersensitive to the signals coming in from the body causing them to be interpreted as pain. Treatment includes Cymbalta and possibly Effexor, Elavil, and Flexeril, as well as Lyrica or Neurontin. Tramadol may be used, but opiate narcotics increase the sensitivity to pain and make the fibromyalgia worse. At least as important as medications is regular modest walking, swimming, water aerobics and stretching exercises and staying active without excessive activity as well as a regular sleep pattern of going to bed and waking up at the same time every day. Endurance is diminished, so frequent short rest periods may be needed to prevent exacerbations. The National Fibromyalgia Association is available for more information.