Fibromyalgia (FM) is a common chronic pain disorder characterized by diffuse musculoskeletal pain and stiffness. It is recognized as a common syndrome affecting 2-4% of the population that may present with several ambiguous and seemingly unrelated symptoms. A broad variety of complaints and lack of tests to accurately identify the disease challenges physicians with confirming this elusive diagnosis. FM has significant overlap with several other systemic diseases including those of sensory hypersensitivity, autonomic deregulation, neurological dysfunction, migraine, and related chronic rhinitis. Current research suggests a relationship between allergic disease especially allergic and NAR and sinusitis. The pathogenesis of FM is related to aberrant pain processing and immunoregulatory abnormalities that may occur in autoimmune disorders with increases in immunologic signaling molecules such as ILs, cytokines, nerve growth factor, which is linked with rhinitis, TNF-alpha, and L-selectin suggesting that pathophysiology is a product of the inflammatory response system. Central nervous system cytokine activation through viral neurotropism and subsequent glial activation is speculated as a possible mechanism. Allergists-immunologists and other specialists such as rheumatologists and rehabilitation and psychiatric physicians may be able to more accurately diagnose and treat these debilitated and often stigmatized patients. The complexity of this disorder must be tackled by a multidisciplinary approach to ensure the successful management of this multifaceted syndrome.