Dear Dr. Gott: After severe back pain and many different meds and treatments, I was diagnosed with fibromyalgia. I took Cymbalta, which helped but it made me lethargic and depressed. I'm now taking Celebrex, which helped for a while, but now the pain in my lower back and hips is so bad that I cannot lie on my side. I am ready to give up. Do you have any advice?

Reply: The pain of fibromyalgia is widespread and can be felt throughout the body. Symptoms vary from person to person and can include joint stiffness, sleep disorders, fatigue, widespread pain and a great deal more. Herein lies the problem, because every symptom can be tied in to other disorders, making it difficult to diagnose.

There is no X-ray testing or laboratory work to confirm or rule out fibromyalgia. Rather, the history a patient presents to his or her physician, coupled with a hands-on examination, will likely tell the story.

Treatment commonly begins with over-the-counter remedies such as ibuprofen, aspirin or naproxen sodium, advancing to prescription medications such as gabapentin, tricyclic antidepressants, SSRIs (selective serotonin reuptake inhibitors) and narcotics. The downside to narcotics is their addictive qualities, which appear to control one condition while replacing it with another damaging one. Physical therapy and an exercise programme might be an appropriate addition to more conservative methods. Water aerobics, deep breathing exercises, massage, chiropractic manipulation, acupuncture, yoga and even counseling might teach a patient methods of successfully dealing with the constant pain. There are options. Therefore, it is important that you enlist the services of a physician well versed in the treatment of fibromyalgia. Don't give up. The condition is an unpleasant, exhausting one but there is help.

To provide related information, I am sending you a copy of my Health Report 'Fibromyalgia'. Other readers who would like a copy should send a self-addressed stamped number ten envelope and a $2 cheque or money order to Newsletter, PO Box 167, Wickliffe, Ohio 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Dear Dr. Gott: I've been diagnosed with asthma, bronchiectasis, lupus and fibromyalgia. I've had a chronic cough, and no one can find out where it's coming from. I have no energy. I just want to take a nap all the time and eat. I've gained weight and can say I'm getting closer to being depressed as opposed to being just unhappy. Any ideas for me to check out?

Reply: Yes. Initially, you should request a referral to a rheumatologist. Lupus, a serious inflammatory autoimmune disorder, can affect the joints, kidneys, lungs and several other parts of the body. Many of the symptoms, such as fatigue, joint pain, anxiety, depression and variations in weight, cross over to those of fibromyalgia. Therefore, you should confirm that you do suffer from both conditions.

You should also be under the care of a pulmonologist for control of your chronic cough, asthma and bronchiectasis. The cough could be medication-induced or a result of your asthma. In order to determine what triggers your attacks, it may be necessary for you to undergo testing and to see several other specialists. This may appear daunting but once your textbook complaints of fibromyalgia are better controlled, you will then be able to lift your veil of depression and get on with your life. There is help. The fact that you have written to me is a genuine indication you are ready to get to the bottom of things.

Dr. Peter H. Gott is a retired physician and the author of several books, including 'Live Longer, Live Better', 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook', which are available at most bookstores or online. His website is www.AskDrGottMD.com. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.