In the general population, the prevalence of fibromyalgia (FM) is estimated as high as 1.8% [1]. Rheumatologists, neurologists, psychiatrists, and other disciplines may be involved to cover the full spectrum of a biopsychosocial model to care for these patients. With high health-care use for up to 10 years before diagnosis [2], FM is considered as an ongoing challenge: (1) different criteria are used for diagnosis – sometimes even without any objective biomarker included, (2) outcome criteria are not widely used in clinical practice and (3) new and promising therapeutic concepts and strategies are missing. An interdisciplinary team last updated the EULAR management recommendations in 2016, recognizing the need of further updates after 5 years [3]. This personal “opinion” summarizes some aspects considered important for the management of FM in clinical routine (Figure 1).