Beyond fibromyalgia: Ideas on etiology and treatment

A common syndrome of musculoskeletal pain, currently called fibrositis or fibromyalgia, accounts for 10-30% of all rheumatology consultations in North America. Lacking a distinctive pathophysiological basis the nature of the pain experienced by these patients remains elusive and treatment is not based on sound scientific principles. An hypothesis is advanced which suggests that skeletal muscle is the 'end organ' responsible for the pain of fibromyalgia and that previous studies on muscle deconditioning and microtrauma may be relevant to the etiopathogenesis of fibromyalgia syndrome.