Fibromyalgia is a common condition that affects 2-4% of the population and is characterized by widespread pain, fatigue, and a number of other symptoms. There is evidence to suggest that fibromyalgia occurs much more frequently than expected in individuals with inflammatory rheumatic disorders. At present, it is not clear whether the inflammatory disorder leads to fibromyalgia or vice versa, but plausible mechanisms exist for either scenario. The coexistence of fibromyalgia and inflammatory disorders can lead to considerable difficulty in both diagnosis and treatment. In this article, the reasons that these two types of disorders can coexist are reviewed, and an approach to the diagnosis and management of individuals with components of both fibromyalgia and an inflammatory disorder is suggested.