[Fibromyalgia syndrome--out of control?]

On account of the very rapid increase in the number of cases and the resulting growing demands on medical resources, the fibromyalgia syndrome now poses a serious challenge to the health service. The diagnostic work-up of the clinical entity is fraught with problems and still leaves open a wide range of differential diagnostic possibilities,. Despite a wealth of pathological findings in the areas of pain physiology, the neuroendocrine system and sleep behaviour, the pathogenesis remains speculative. Accurate assessments of function in those affected are not possible, and evaluations of impaired performance only to a limited degree. The confusing multiplicity of therapeutic approaches, and the results of long-term studies of the natural history of the condition reflect the very limited efficacy of currently available treatment strategies.