Fibromyalgia Fibrositis or Myofascial Pain Syndrome This is a musculoskeletal pain syndrome whose exact cause has not been identified, most commonly occurring in women 20 to 50 years old.  Contributing factors include sleep disorders (loss of non REM stage IV), weather changes, viral infections, Depression, Hypothyroidism, Rheumatoid Arthritis, and Sleep Apnea.  Chronic Fatigue Syndrome has many symptoms that overlap with fibromyalgia. Aching/stiffness usually occurs in neck, shoulders, low back, and hips; but can affect the whole body Fatigue Headaches Sleep problems Irritable Bowel Syndrome Numbness Depression Pain may improve with stress reduction, and increase with stressful activities and anxiety. Exercise helps to reduce the pain. Pressure on trigger points produces the pain. Trigger points of tenderness are found on exam Diagnosis is made by excluding other causes such as lupus, hypothyroidism, or arthritis Graded exercise programs Nonsteroidal anti-inflammatories such as aspirin, Motrin, and others may help with pain. Amitriptyline (Elavil) before bed Cyclobenzaprine before bed Stress reductions, such as meditation and a change of environment may help. With narcotic painkillers (e.g., codeine, etc.) and sleeping pills, there is a risk of addiction.  Discuss the risks with your doctor. Rheumatoid Arthritis Systemic Lupus Erythematosus Polymyalgia Rheumatica Hypothyroidism Mononucleosis Sleep Apnea Depression Chronic Fatigue Syndrome