Newswise — Pain all over, fatigue and difficulty sleeping -- and no measurable answer for what could be wrong.

That scenario may be familiar for the estimated 2 percent of Americans affected by fibromyalgia. The April issue of Mayo Clinic Health Letter describes this sometimes frustrating condition and the cornerstones of successful treatment.

Fibromyalgia is a collection of symptoms that include fatigue and sleep problems. A frustrating condition, fibromyalgia can be confounded by the difficulty in diagnosing it. Symptoms vary, don't follow a pattern and may include digestive problems, headaches, mood changes, facial pain, difficulty concentrating, numbness and tingling in the fingers, and sensitivity to odors, noise, bright lights and other stimuli. General criteria for diagnosing fibromyalgia include widespread pain that lasts for at least three months and excess tenderness in at least 11 of 18 specific spots on the body.

Once fibromyalgia is determined, a multipronged treatment approach often leads to enough symptom relief to resume daily activities. For people whose fibromyalgia is not severe, a few manageable changes can make a big difference. Those who have more severe symptoms might benefit from treatment at a chronic pain or fibromyalgia clinic. Treatment includes:

Education: Learning more about how to manage symptoms is important for better symptom control.

Exercise: Perhaps difficult at first, exercise promotes fitness, which can improve well-being, increase stamina, decrease pain and help with sleep.

Stress reduction: Daily meditation or deep breathing exercises can reduce stress. Better sleep: Going to bed and waking at a consistent time each day can aid sleep, as can avoiding alcohol, caffeine, nicotine or exercise within a couple hours of bedtime.

Cognitive behavior therapy sessions: Therapy can help manage anger, stress and anxieties that may contribute to -- or result from -- fibromyalgia symptoms.

Complementary therapies: Heat packs or hot baths, massage therapy, acupuncture and chiropractic therapy may help relieve stress and reduce pain.

In addition, medications can help reduce fibromyalgia pain and improve sleep. Medication options include antidepressants, anti-seizure drugs, muscle relaxants, over-the-counter pain medications and certain drugs for Parkinson's disease.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9PR1, or visit

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