Fibromyalgia is hard to diagnose, since there is no specific test for this disease. It is characterized by muscle pain that is not constant and not confined to one place on the body. Usually there are tender points on the body that are unusually sensitive to pressure. These spots are used to make the diagnosis; they tend to be on the top of the shoulders, between the shoulder blades, at the back of the head, in the front of the neck, around the knees, hips, elbows and front of the chest. Symptoms may be aggravated by cold, stress and lack of sleep. Associated conditions include headaches, depression, irritable bowel syndrome, arthritis, abnormal menstruation and post traumatic stress.