I met a patient who has been ill for a few years now, and is on disability unable to work, but still has no diagnosis. I was wondering if anyone here perhaps has an idea what this could be? Primary problem is continuous muscle contractions, knots in muscles, muscle cramps (particularly after exercise). There is also fatigue. They have suffered from anxiety for 12 years, which preceded this more recent muscle problem. They have tested positive for Rheumatoid Factor once, but on a subsequent test, this was negative. Their doctor is holding off referring to a rheumatologist for now. They have elevated leukocytes. "Chronic fatigue syndrome" and fibromyalgia have been mentioned, but not diagnosed. Acupuncture, massage therapy, supplements have not helped to date.