I was recently asked to present something on Fibromyalgia. Since the audience would be colleagues “familiar” with this disease (Rheumas, Rehabs, Neuros), I opted to present updates – the updated definition (which now includes symptoms other than pain and tenderness), the evolution of diagnostic criteria (from 1990 ACR to the latest 2010 ACR), and synthesized some aspects of several guidelines. I had foregone presenting efficacy data on pregabalin, duloxetine and milnacipran because they have already been specifically approved for fibromyalgia – meaning they work and (I feel) there’s no need to add to that. Instead, I presented what fibromyalgia patients experience as far as the two most common drugs used in terms of efficacy and safety. The last slide is actually a reminder why fibromyalgia is difficult to manage – and why the 2012 guidelines had to specify the behavioral “requirements” for those managing fibromyalgia.