Duloxetine has shown efficacy for several chronic pain conditions (Sultan 2008) including fibromyalgia, and appears to be more effective in women than men (Arnold 2004, 2005). It is well tolerated and effective at a dose of 60 mg daily ( Sultan 2008). Studies in patients with fibromyalgia (Arnold 2004, 2005), diabetic neuropathy (Goldstein 2005), low back pain (Skijaravala 2008), and osteoarthritis (Chappell 2008) have shown an analgesic effect at this dose with fewer adverse effects and a lower drop out rate than higher doses. In the proposed study, subjects randomized to the intervention will use 60 mg of duloxetine given as 30 mg twice daily after a one-week period of 30 mg daily.