Fibromyalgia

Description

Prognosis

Fibromyalgia can be mild or disabling, and the emotional repercussions can be substantial. About half of all patients have difficulty with or are unable to perform routine daily activities. Estimates of patients who have had to stop work or change jobs range from 30% to 40%. In a 2003 study, patients with either CFS or fibromyalgia were more likely to suffer losses of jobs, possessions, and support from friends and family than people suffering from other conditions that caused fatigue.

Risk of Negative Behaviors

The pain, emotional repercussions, or sleep disturbances may lead to self-medication and overuse of sleeping pills, alcohol, drugs, or caffeine. One 2001 study also reported a higher incidence of violent deaths, including suicide and accidents, among people with widespread pain.

Long-term Outlook

Outlook in Adults. Some studies indicate that fibromyalgia symptoms remain stable over the long term, while others report a better outlook, with between 25% and 35% of patients reporting improvement in pain symptoms over time. Studies suggest that regular exercise specifically improves outlook in patients. For example, in one study of adult patients after four and a half years, those who had adequate exercise had the most promising outcome. Those with a significant life crisis or who were on disability had a poorer outcome than others. Outcome was determined by improvements in the patients' capacity to work, their own feelings about their condition, pain sensation, disturbed sleep, fatigue, and depression.

Although the disease is chronic, it is neither progressive nor fatal, and remission can occur in many patients who participate in disease management programs. Patients with secondary fibromyalgia, particularly when it is caused by injury, tend to have a more severe and less easily treated condition than those with primary fibromyalgia.

One 2001 study did find higher mortality rates in patients with widespread pain compared to those without chronic pain. The higher rate was mostly due to a greater risk for cancer in the long term, although the reason for this association is unknown.

Outlook in Children. Children with fibromyalgia tend to have better outlooks than adults do.