Patients with chronic pain usually experience symptoms lasting several months to years.[101]Mäntyselkä P, Kumpusalo E, Ahonen R, et al. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001 Jan;89(2-3):175-80.
http://www.ncbi.nlm.nih.gov/pubmed/11166473?tool=bestpractice.com
Patients reporting pain persisting more than 3 months should be actively treated and not recommended to wait for spontaneous improvement.
Back pain
In most cases, episodes of acute back pain resolve with conservative, symptomatic treatment.[102]Valat J, Goupille P, Rozenberg S, et al. Acute low back pain: predictive index of chronicity from a cohort of 2487 subjects. Joint Bone Spine. 2000;67(5):456-61.
http://www.ncbi.nlm.nih.gov/pubmed/11143914?tool=bestpractice.com
Back pain that persists beyond the acute period often persists long-term.[103]Schiøttz-Christensen B, Nielsen GL, Hansen VK, et al. Long-term prognosis of acute low back pain in patients seen in general practice: a 1-year prospective follow-up study. Fam Pract. 1999 Jun;16(3):223-32.
https://academic.oup.com/fampra/article/16/3/223/485577
http://www.ncbi.nlm.nih.gov/pubmed/10439974?tool=bestpractice.com
[104]Croft PR, Macfarlane GJ, Papageorgiou AC, et al. Outcome of low back pain in general practice: a prospective study. BMJ. 1998 May 2;316(7141):1356-9.
https://www.bmj.com/content/316/7141/1356.full
http://www.ncbi.nlm.nih.gov/pubmed/9563990?tool=bestpractice.com
[105]Thomas E, Silman AJ, Croft PR, et al. Predicting who develops chronic low back pain in primary care: a prospective study. BMJ. 1999 Jun 19;318(7199):1662-7.
https://www.bmj.com/content/318/7199/1662.full
http://www.ncbi.nlm.nih.gov/pubmed/10373170?tool=bestpractice.com
Myofascial pain
Symptoms characteristically persist long-term, often waxing and waning with periods of more and less disabling pain. For example, a survey of patients with chronic myofascial pain at one centre reported an average pain duration prior to evaluation of 63 months, with a range of 6 to 180 months.[106]Gerwin RD. Classification, epidemiology, and natural history of myofascial pain syndrome. Curr Pain Headache Rep. 2001 Oct;5(5):412-20.
http://www.ncbi.nlm.nih.gov/pubmed/11560806?tool=bestpractice.com
Fibromyalgia
Complete remission from fibromyalgia occurs rarely.[107]White KP, Harth M. Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep. 2001 Aug;5(4):320-9.
http://www.ncbi.nlm.nih.gov/pubmed/11403735?tool=bestpractice.com
However, most patients experience substantial symptomatic improvement and reduced reliance on medicines when followed over 3 years.[108]Pöyhiä R, Da Costa D, Fitzcharles MA. Pain and pain relief in fibromyalgia patients followed for three years. Arthritis Rheum. 2001 Aug;45(4):355-61.
https://onlinelibrary.wiley.com/doi/full/10.1002/1529-0131%28200108%2945%3A4%3C355%3A%3AAID-ART348%3E3.0.CO%3B2-K
http://www.ncbi.nlm.nih.gov/pubmed/11501723?tool=bestpractice.com