Chronic widespread pain as a medico-legal issue

A systematic approach to the determination of disability in persons with ch ronic widespread pain is based on a careful history, examination for tender points, and special investigations to establish a firm diagnosis. Further assessment requires determination of subjective and objective measures of i mpairment. The causes of fibromyalgia are multifactorial and understanding them requires an appreciation of the role of physical or psychological trau ma, and associated medical and psychosocial factors. Despite the presence o f disability risk factors, most patients with fibromyalgia maintain a good range of normal daily activities and continue working.