Transcranial Magnetic Stimulation for Treating Women With Chronic Widespread Pain

Inclusion Criteria: * Diagnosis of chronic widespread pain as defined by the 1990 American College of Rheumatology guidelines: chronic musculoskeletal pain for at least 3 months; pain above and below the waist; pain on both right and left sides; pain at one axial site (e.g., head, neck, spine, or back) * Willing to remain on a stable medical regimen during the entire 6-week course of Phase 1 treatment and 8 weeks prior to rTMS treatment * Willing to undergo random assignment and able to attend treatment sessions * Willing to remain on a stable psychotherapy regimen if currently receiving psychotherapy that has been ongoing for at least 3 months prior to study entry Exclusion Criteria: * Unable to maintain treatment as usual at stable doses for any medical or psychiatric conditions for 8 weeks prior to and during the study * Another medical condition associated with significant pain (e.g., diabetic neuropathy, systemic lupus erythematosus, Rheumatoid arthritis, severe degenerative joint disease) * Any condition that might increase the risk of seizures from TMS * History of a seizure disorder or family history of a seizure disorder * Previous use of TMS * Involvement in litigation or disability that is related to fibromyalgia, chronic widespread pain, or depression * Current use of proconvulsant medications (e.g., bupropion) * Metal in the body that would prevent magnetic resonance imaging (MRI) or TMS (e.g., aneurysm clips, pacemakers, neurostimulators) * History of head injury associated with loss of consciousness for more than 15 minutes, brain surgery, or lithium toxicity * History of bipolar disorder, schizophrenia, obsessive compulsive disorder, panic disorder, or post-traumatic stress disorder * Current substance abuse or dependence * Active suicidal intent or plan * Severe claustrophobia that would prevent MRI * Major depression with psychotic features or a current major depressive episode lasting longer than 5 years * Pregnant