Good Narrative. The trifecta for fibromyalgia is poor sleep, poor exercise and poor control of stress and other psychological issues. They can have one, two or all three. I encourage therapy directed to all three. There is no major answer as each person is different. They often don't get respect and as David notes can confound many different medical problems. Some Colleagues won't make the diagnosis thus sparing the discussion. Often reviewing the multiple answers on the history form can quickly be a clue. My staff can make the diagnosis on the entry telephone call. Don't be fooled and always look for some of the associated illnesses which also can co-exist.