Fibromyalgia is a multisystem disorder which presents as a chronic pain condition. More and more scientific evidence points to its being a neurological rather than a rheumatological condition. However, Fibromyalgia is and will remain under the auspices of the speciality of rheumatology.

The American College of Rheumatologists Diagnostic Criteria of 1990 are both respected and robust. Predominantly, these criteria are used by specialist physicians rather than primary care doctors so the diagnosis is largely arising from secondary level care. The diagnosis of Fibromyalgia is often associated with a lengthy time lag and extensive testing to exclude other diagnoses. Once the diagnosis is made, however, there is both relief that its "not all in the head" and frustration at not being able to get concerted help for these multiple symptoms.

While soft time tissue pain is the predominant symptom, almost every organ and tissue system is capable of generating complaints or consequences. Sleep disruption and fatigue are also core features. Added to this may be a litany of symptoms which may include, for example:

• Bloating/Gastro-Intestinal Disturbance
• "Heavy"/Restless Legs
• Cold Extremities
• Headaches/Dizziness
• Low Mood/Anxiety
• Poor Memory/Clouded Thinking
• Joint Pains/Stiffness
• Recurrent Infections
• Sinus/Temporomandibular (Jaw) Pain

Each sufferer presents with multiple combinations and permutations of the above symptoms. Many symptoms are part of an unfortunate cycle of initiation and perpetuation. All destructive cycles have to be stopped, some of which are straightforward, while some are quite difficult.