[Fibromyalgia--an update]

Fibromyalgia is a common, female dominated condition, characterized by chronic widespread pain, fatigue, sleep disturbance, anxiety/depression and a number of other symptoms. The syndrome's aetiology and treatment is disputed. However, research over the last decade has provided substantial new information.

This review is an update on fibromyalgia with respect to predictors, pathogenesis and treatment. On the basis of a number of important scientific publications, the most relevant theory is presented and discussed.

Fibromyalgia may be described as a biopsychosocial disorder in which long lasting distress, myofascial pain, central sensitisation, sickness behaviour, anxiety/depression, neuroendocrine and autonomic dysfunction play central aetiological roles as elements in a vicious circle. Treatment should be focused on each of these elements and requires active patient participation. It is best given as a multidimensional, multidisciplinary rehabilitation programme with continuous support from the general practitioner.

Even though the fibromyalgia riddle is not yet fully solved, research over the last decade has given valuable new information on pathogenesis and treatment. We should be able to offer our patients substantial help on the basis of present knowledge.