from goldenberg arch intern med conclusions fibromyalgia is a clinical syndrome medicines that affect pain perception sleep and mood have been useful and should be integrated with activity exercise and educational programs most patients with fm observed in tertiary referral centers report little change in their symptoms over time the outcome is directly related to psychosocial factors including past and current psychological distress and work status or disability issues as with any chronic illness patients in the community do better than those observed in specialty clinics ten percent to of patients describe being work impaired from fm physicians should discourage inactivity and disability because if these are prolonged there is an adverse effect on prognosis finally patients have found a diagnostic label to be reassuring and the diagnosis has decreased costly testing and health care use emphasis added