Prognosis

Long-term cohort studies in the Americas and Europe found no significant change in FMS prognosis over a sixto eight-year period.6,125 Severity of pain, fatigue, disability, and quality of life remains unchanged. In America, the annual healthcare cost of FMS in 1996 was $2274 per patient. Confronted by such worrying statistics, the Chief Medical Officer in the UK wrote to all the doctors in the UK emphasizing the healthcare burden of chronic widespread pain, urging that more research is essential to address the problem and improve outcome.

For FMS, although it is rare for symptoms to subside completely, if patients are able to learn to manage their chronic pain and adopt effective coping behavior, it is unlikely that the pain will progress and may in fact reduce, although the patients remain symptomatic. Unfortunately, the lack of an effective treatment for all symptoms, or all sufferers, means that a multidimensional approach will most likely be required and a number of interventions may have to be used before the most appropriate for each individual is determined. The prognosis is linked to the severity or range of symptoms experienced by the individual concerned. Those with fewer symptoms may be better able to manage their syndrome with education and coping behaviors, whereas patients with a more wide range of FMS-related symptoms, or more severe spectrum, are more likely to require a more complex approach which may have a less positive long-term prognosis. It is important that the patients realize that complete remission is rare for them to be able to manage the pain better.

In MFP the prognosis is generally good.22 With effective treatment and education in postural and/or mechanical behaviors to reduce recurrence of the trigger point, it is likely that once treated the pain may not return.

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