As recently as a decade ago, fibromyalgia "was considered a wastebasket type of diagnosis for any patient with chronic musculoskeletal pain" that couldn't otherwise be explained, according to rheumatologist Russell Rothenberg, assistant professor of medicine at George Washington University Hospital. Before the American College of Rheumatology issued its diagnostic criteria for fibromyalgia in 1990, Rothenberg says, "doctors either didn't believe their patients or knew that they had pain but didn't know how to treat it."

In Ohio, a study is recruiting 180 patients to evaluate the effects of what researchers call two of the most promising non-drug treatments for fibromyalgia: coping skills training and physical exercise training. Investigators want to evaluate how changes in aerobic fitness, self-effectiveness and negative pain-related thoughts relate to improvements in pain and disability. A study in Durham, N.C., will test the effectiveness of cognitive behavioral therapy for the insomnia that often accompanies fibromyalgia.

Further complicating matters is the fact that fibromyalgia--in a form known as secondary fibromyalgia--may occur alongside other illnesses. For example, one-third of patients with systemic lupus also have fibromyalgia, as do one-third of those with irritable bowel syndrome. The condition also appears in some people with rheumatoid arthritis. (Fibromyalgia unaccompanied by other diseases is primary fibromyalgia.)