Fibromyalgia syndrome (FMS) is a chronic and debilitating musculoskeletal pain disorder of unknown origin characterized by chronic widespread pain and muscle tenderness and the presence of tender points on examination. Patients experience both pain from a normally nonpainful stimulus and inappropriately intense pain from a normally painful stimulus. Other common accompanying features are fatigue, sleep disturbances, stiffness, paraesthesias, headaches, Raynaud's like symptoms, depression and anxiety. FMS is much more than widespread pain as it overlaps substantially with other central sensitivity syndromes such as chronic fatigue syndrome, irritable bowel syndrome, chronic pelvic pain syndrome/ primary dysmenorrhoea; temporomandibular joint pain TMJ, multiple chemical sensitivity, restless legs syndrome and interstitial cystitis.
Over the last decade, abnormalities have been identiﬁed at multiple levels in the peripheral, central, and sympathetic nervous systems as well as the hypothalomo-pitutary-adrenal axis stress response system. Fibromyalgia Syndrome is known more as a central sensitivity syndrome. There has been much interest in both pharmacological and non-pharmacological treatment of Fibromyalgia syndrome, FMS. The United States Food and Drug Administration (FDA) has successively approved 3 drugs for the management of ﬁbromyalgia, but Non-pharmacological modalities; aerobic exercise, patient education and cognitive behavioral therapy showed to be the most effective. Overall, management of FMS requires a multi-disciplinary approach.