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Fibromyalgia

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of fibromyalgia.

Alternative Names

Fibromyositis; Fibrositis; Myofascial pain syndrome

Prognosis

Fibromyalgia can be mild or disabling, and the emotional toll can be substantial. About half of all patients have difficulty with routine daily activities, or are unable to perform them. Estimates of patients who have had to stop work or change jobs range from 30 - 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 consequences, or sleep disturbances that come with fibromyalgia 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 show that fibromyalgia symptoms remain stable over the long term, while others report a better outlook, with between 25 - 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 4.5 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' ability to work, their own feelings about their condition, pain sensation, and levels of disturbed sleep, fatigue, and depression.

Although the disease is life-long, it does not get worse and is not fatal. Remission -- the absence of any signs of disease activity -- can occur in many patients who participate in disease management programs. Patients with secondary fibromyalgia, particularly one caused by injury, tend to have a more severe and less easily treated condition than those with primary fibromyalgia.

Outlook in Children. Children with fibromyalgia tend to have better outlooks than adults with the disorder. Several studies reported that over half of children with fibromyalgia recover in 2 - 3 years.

• Review Date: 12/15/2006
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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