Currently, Fibromyalgia syndrome (FMS) is primarily diagnosed when a patient has 11 tender points (out of a possible 18) in all 4 quadrants of the body. This criteria was developed by the American College of Rheumatology (ACR) in 1990.

In 1994, the Vancouver Fibromyalgia Consensus Group, (VFCG), convened and found fibromyalgia presents several clear issues:

1. Fibromyalgia is not an epidemiologically distinct disease.
2. Patients generally feel a lack of support from family and friends and, although employable, have a difficult time holding onto a job due to cyclic nature of symptoms.
3. Both physical and psychological treatments are needed.
4. A better standardized way to diagnose FMS is needed.

Bottom line: Fibromyalgia is difficult to treat, regardless of which field of health is used for treatment because the symptoms of the disease present differently from person to person. Often an interdisciplinary approach is needed, and should continue to be patient driven, focusing on:

1. Pain relief
2. Limitation of chronicity (cycles of various symptoms).
3. Management of coping behavior.
4. Rehabilitation of physical functioning.

The authors of Fibromyalgia: revisiting the literature, suggest that patients be categorized by sub-type and treated accordingly based upon each patient’s specific needs. Some get effective treatment from one practitioner, while others need a multiplicity of practioners. Even so, fibromyalgia continues to be resistent to treatment in any clinical setting.