DEAR DR. DONOHUE: Regarding fibromyalgia: You stated that there are simple tests that reveal it. My 50-year-old daughter has the symptoms. She has pain in the hips, legs and now the neck and shoulders and has had it for two years. Her doctor knows of no tests for it. Please inform me. — M.L.

ANSWER: I am kicking myself for implying that there are simple tests for fibromyalgia. That’s wrong.

Fibromyalgia is a condition afflicting 5 million Americans. The symptoms are all-over pain, fatigue, fragmented sleep that leaves people groggy during the day, trouble organizing one’s thoughts and the presence of tender points — specific places on the body where pressure from the doctor’s examining finger elicits pain far beyond the amount of pressure applied to the site. That’s what I meant by simple tests. The presence of 11 of 18 recognized tender points is evidence for fibromyalgia. These days, the significance of tender points is downplayed. People can have the condition without having tender points.

No lab tests, no X-rays and no scans disclose this illness. Neither does the ultimate in medical tests — a biopsy. Testing for other illnesses that have signs similar to those of fibromyalgia is important to exclude those illnesses as a cause of a person’s pain and symptoms. Such illnesses are rheumatoid arthritis, lupus, polymyalgia rheumatica and others.

Fibromyalgia is believed to be an amplification by the brain of pain signals that reach it. It’s like listening to a radio with the volume turned to the highest possible level at all times. Medicines are available that can help some patients to turn the brain’s pain volume down.

Pregabalin (Lyrica), gabapentin (Neurontin), amitriptyline, duloxetine (Cymbalta) and milnacipran (Savella) are examples of medicines that have met with success in some patients. Physical activity is another approach to treatment. The level of activity has to be modest at first — a short walk — with gradual increase in the amount and intensity of exercise.

The booklet on fibromyalgia can clear up some of the misunderstandings about it. Readers can obtain a copy by writing: Dr. Donohue — No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have had herpes viral infection of the eye several times in the past seven to 10 years. One doctor thought it was from the Fosamax I took. Another said it was from constant stress and a weakened immune system. What do you think causes it? — M.M.

ANSWER: The cause is the herpes simplex virus, the same virus that causes cold sores. Recurrences are expected with herpes infections. The virus lives on in nerve cells and comes out of those cells from time to time to travel to, in your case, the eye. Antiviral eyedrops usually can combat a flare. Nothing eliminates the virus for good. An eye doctor should be taking care of you for this infection.

DEAR DR. DONOHUE: I am losing my voice to spasmodic dysphonia and essential tremor. Is there treatment other than Botox? — L.F.

ANSWER: Speech production involves air passing through partially closed vocal cords. Muscles control the vocal cords. With spasmodic dysphonia, the muscles are constantly contracted and produce a strained and stressed voice with many breaks in it. Whispering is usually fluent, but no one can go about whispering all the time. Botox is the most effective treatment for this condition.

Do you mean that essential tremor also affects your voice? That’s possible. It’s an inherited condition that can affect the vocal cords and cause a tremulous voice. Propranolol and primidone often can control essential tremor.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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