This pattern of sleep deprivation did not induce symptoms of fibromyalgia in aerobically conditioned individuals. Patients with fibromyalgia often have a variety of other symptoms, including headache, irritable bowel syndrome, atypical Raynaud's phenomenon, paresthesia, sensations of swelling, and psychological changes such as depression. Tissues adjacent to tender points are not tender, which provides a semiobjective characterization of the disease. The diagnosis of fibromyalgia is based on the history of widespread pain and the finding of tender points at several specific sites. If the distribution of pain and tenderness is localized rather than widespread, it is more likely that the patient has a myofascial pain syndrome.
Therapy is usually only partly effective.
Nonsteroidal anti-inflammatory drugs and glucocorticoids are ineffective, which is consistent with the lack of evidence of inflammation. Cardiovascular fitness training and aerobic exercise programs, as well as biofeedback training, have been found to be effective in many patients. The course of the disease is chronic. Although partial improvement of symptoms commonly occurs with treatment, most patients have persistent symptoms for many years. Complete remission occurs in only a few patients, and relapse occurs often.