Myofascial pain syndromes have a very high prevalence. Two concepts are essential: muscular tension and trigger points. Autonomous and central sensitization components are implicated. Physical examination and a complete clinical his- tory are mandatory. It requires a multidisciplinary treatment, especially with physical therapy. Fibromyalgia is characterized by chronic widespread pain and the presence of tender points.

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In its origin numerous the- ories exist, but none is totally accepted. Patients present mor- ning rigidity, chronic fatigue, cephalalgia, sleep disturbances, paresthesia, mood disorders, irritable bowel and joint pain. The diagnosis is based upon the classification criteria of the American College of Rheumatology 1990. The treatment aims to recover functionality and quality of life, at least partially. Tricyclic antidepressants therapy will improve depression and sleep disturbances. The non pharmacological treatment with stretching and relaxation programs alongside psychological therapy will help to reduce the intensity of symptoms.