Fibromyalgia is a chronic illness that goes through cycles of improvement and flare ups. It has no cure, but with education, lifestyle changes, and proper medications, the individual can regain control and achieve significant improvement.
The treatment goal that responds least to therapy is improvement in daily functioning. Most patients assume that stopping work will improve their symptoms, yet many studies have shown that with disability, symptoms worsen.
The prognosis varies according to the patient; there are 3 subsets: adaptive copers, interpersonally distressed, and dysfunctional. Adaptive copers, who often do not seek medical care, do well with respect to pain, sleep, and fatigue. Interpersonally distressed patients may respond to resolution of life and counseling. Dysfunctional patients have high levels of pain and anxiety, significant impairment in daily activities, and, frequently opioid dependence. These patients fair the worst.
Other patient characteristics associated with poor prognosis include the following:
High levels of distress
Long-standing fibromyalgia
Major psychiatric disease or severe depression and anxiety that responds poorly to treatment
Persistent work avoidance
Marked functional impairment despite multidisciplinary approaches to treatment
Opioid or alcohol dependence
Fibromyalgia is not a life-threatening, deforming, or progressive disease. Without proper diagnosis and treatment, however, a patient with fibromyalgia may have the illusion of disease progression. This illusion is not a result of the disease itself but rather due to sleep deprivation and physical loss of function.
Fibromyalgia is a chronic disease which does not heal completely but had periods of "des haut et des bas". The treatment is antidepressive, improvement of sleep and moral
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