Although in itself fibromyalgia is neither degenerative nor fatal, the chronic pain of fibromyalgia is pervasive and persistent. Most people with fibromyalgia report that their symptoms do not improve over time. However, most patients learn to adapt to the symptoms over time. The German guidelines for patients explain that: # The symptoms of fibromyalgia are persistent in nearly all patients. # Total relief of symptoms is seldom achieved. # The symptoms do not lead to disablement and do not shorten life expectancy. An 11-year follow-up study on 1555 patients found that most remained with high levels of self-reported symptoms and distress. However, there was a great deal of patient heterogeneity accounting for almost half of the variance. At the final observation, 10% of the patients showed substantial improvement minimal symptoms. An additional 15% had moderate improvement. This state, though, may be transient, given the fluctuations in symptom severity. A study of 97 adolescents diagnosed with fibromyalgia followed them for eight years. After eight years, the majority of youth still suffer from pain and disability in physical, social, and psychological areas. At the last follow-up, all participants reported experiencing one or more fibromyalgia symptoms such pain, fatigue, and/or sleep problems, with 58% matching the complete ACR 2010 criteria for fibromyalgia. Based on the WPI and SS score cut-points, the remaining 42% exhibited subclinical symptoms. Pain and emotional symptom trajectories, on the other hand, displayed a variety of longitudinal patterns. The study concluded that while most patient's fibromyalgia symptoms endure, the severity of their pain tends to reduce over time. Baseline depressive symptoms in adolescents appear to predict worse pain at follow-up periods.
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