The past centennium has witnessed scientific progress in the elucidation of the mechanisms involved in the formal pathogenesis of so-called muscular pathogenesis of so-called muscular rheumatism (recently fibromyalgia), but the aetiology of this widespread syndrome and the pathways to its appropriate treatment are still not known. Careful diagnosis based on consideration of numerous conditions relevant for differential diagnosis, patient education and shared decision-making are prerequisites to the efficacy of a complex treatment and rehabilitation plan which should comprise a reasonable combination of physio-, psycho-, and pharmacotherapeutic measures. Medication should be sparingly prescribed and the patient advised that in the end these drugs have a symptomatic effect only. Ultimately, active participation which the physician should continuously demand of the patient is imperative to the success of treatment.
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