Fibromyalgia is a common condition and it's associated with generalise pain - particularly around the shoulders and neck but also elsewhere in the body.

The cause is not well understood although newer research is beginning to throw some light on what might be going on in the nervous system of those who are afflicted by it. Many cases of fibromyalgia overlap with conditions like carpal tunnel syndrome and frozen shoulder.

Fibromyalgia tends to cause widespread or generalised pain and the pain is often chronic. Most patients find it difficult to get a diagnosis in the first instance and often complain thereafter that their treatment was haphazard and poorly co-ordinated. Many family doctors are not familiar with modern approaches to chronic pain in general.

Chronic pain is probably much more common in the population than is realised - one recent study found that 13 percent of us have pain at any given time - and have had that pain for at least a month.

 Studies suggest that pain is a much more common problem in the community than many doctors realise.

What about you - as you read this?

Do you have pain right now?

 Fibromyalgia is a condition that causes chronic joint and muscle pain.

It is often associated with a poor sleep quality, shorter duration of sleep, a sense of overwhelming fatigue, low mood or depression, stiffness and widespread pins and needles or paresthesia.

Many people with fibromyalgia often also suffer from chronic headache, chronic fatigue syndrome, irritable bowel syndrome or bladder problems.

Recent research shows that two people in every hundred have some of the symptoms of fibromyalgia at some time in their lives. Women get it much more often than men and it seems to get more common as people get older.

In the USA, fibromyalgia is the second most common condition treated by specialist rheumatologists.

 Despite a lot of research it's still not clear what actually causes fibromyalgia.

Some experts think it's triggered by sleep problems, others blame nerve pathway problems or nerve transmitter chemicals and yet others say that mood changes, stress and psychological factors are important.

Certainly a poor quality of sleep is commonly found in people with fibromyalgia. A reduction in REM or "dream sleep" is always found in association with the condition. But is this the cause - or just an effect of fibromyalgia?

If normal volunteers are subject to prolonged sleep deprivation then they all develop symptoms and signs that are hard to distinguish from true fibromyalgia - including low mood, stiff joints and sore tender trigger spots.

People with fibromyalgia also show nerve changes that make the body react differently to pain or to touch. This hypersensitivity of nerve endings is always present and again, scientists wonder if it is the cause or an effect of fibromyalgia developing. Severe responses to heat or cold are also often present.

Brain imaging tests have shown blood flow changes to certain parts of the mid brain in those suffering from the fibromyalgia syndrome - raising possibilities for future treatment options.

There is no one drug or combination of drugs that is certain to be effective in treating fibromyalgia - but having said that the studies have often been low quality and not very well conducted, so it's hard to draw firm conclusions about it.

Some people find that taking simple analgesics with tylenol or codeine are helpful.

No research suggests that anti-inflammatory meds are helpful.

About a third of people seem to get help from taking low doses of a drug called amitryptilline. This helps with fatigue in particular but can also be good for pain. A lot of research has focussed on SSRI drugs like prozac or fluoxetine but the results are mostly disappointing - although some have found them good for sleep and others have become less low in mood when taking them.

Non drug therapies for fibromyalgia include acupuncture, biofeedback, hypnosis and exercise related therapy. Some people also claim benefits for Reiki and aromatherapy and the Bowen technique.

Cognitive behavioural strategies are often useful things to learn if you suffer from fibromyalgia.

You can read more about the joint pain and shoulder pain aspects of fibromyalgia here.