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Fibromyalgia (FM) is a common, costly, and often highly debilitating disorder marked by a history of widespread body pain, including spinal pain. During the physical exam, the patient commonly experiences pain as the examiner presses with minimal stress (4 kg) on selected muscle-tendon junctions. The clinical presentation of FM often includes symptoms reaching beyond pain, including fatigue, sleep disturbance, stiffness, cognitive difficulties, tenderness, and difficulty exercising at an age-expected norm. Moreover, many other illness are comorbid in FM, including irritable bowel and bladder, headaches, temporomandibular joint dysfunction, pelvic pain (endometrosis, vulvodynia, vulvar vestibulitis), and restless legs syndrome.

Despite 3 decades of mounting objective patho-physiological evidence and the advent of FDA-indicated medications specifically for FM, the disorder remains controversial. Even 18 years after the American College of ...

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