Fibromyalgia also affects children, primarily adolescent girls. Symptoms include widespread pain, headaches and sleep problems.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.
Fibromyalgia is commonly thought of as a condition that affects adults. However, fibromyalgia also occurs in children and adolescents. Estimates suggest that juvenile-onset fibromyalgia affects 2% to 6% of schoolchildren, mostly adolescent girls. It is most commonly diagnosed between ages 13 and 15.
In some children, symptoms begin after a triggering event, such as physical trauma, surgery, infection or prolonged psychological stress. In other children, symptoms gradually accumulate over time with no single triggering event.
In children with fibromyalgia, signs and symptoms include:
Doctors don't know why some people develop fibromyalgia and others don't. There appears to be a genetic component because the condition tends to run in families. In some people, it may be triggered by specific events, injuries or illnesses.
Researchers believe repeated nerve stimulation causes changes in the brain and spinal cord of people with fibromyalgia. These changes include an abnormal increase in levels of certain chemicals in the brain that signal pain. In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become sensitized, meaning they can overreact to painful and nonpainful signals.
Risk factors for fibromyalgia include:
The pain and lack of sleep associated with fibromyalgia can interfere with the ability to function at school or at home. The frustration of dealing with an often misunderstood condition can result in depression and anxiety.
In the past, doctors would check specific points on a person's body to see how many were painful when pressed firmly. Newer guidelines don't require a tender point exam.
Instead, a fibromyalgia diagnosis can be made, using adult guidelines, if a young person has had widespread pain throughout the body for at least three months. Widespread is defined as pain on both sides of the body, as well as above and below the waist.
Your doctor may also order blood tests or X-rays to help rule out other problems that might be causing the symptoms.
Treatment for juvenile fibromyalgia may include exercise programs, counseling and medications.
Many children who have fibromyalgia avoid activity because they're afraid it will cause more pain. It may help to start with strength-training exercises to improve gait, posture and balance. Activities such as biking, swimming or water aerobics can be added gradually.
Cognitive behavioral therapy is a type of talk therapy that has been well studied in the treatment of chronic pain in children. It focuses on helping them manage their pain using techniques such as relaxation-based treatments, distraction and thought stopping. These techniques can help reduce disability and depression. Combining an exercise program with cognitive behavioral therapy can provide significant benefit.
Medications can help reduce the pain of fibromyalgia and improve sleep. Data on the use of medications in the treatment of juvenile fibromyalgia is limited. However, drugs that have shown benefit in adults have also been used in children and are sometimes effective. Common choices include:
Self-care is critical in the management of fibromyalgia:
Yoga, tai chi and qigong combine meditation, slow movements, deep breathing and relaxation. In adults with fibromyalgia, these practices can decrease sleep problems, fatigue and depression. The same may be true for children as well.
Other related strategies include massage and acupuncture; these practices can also help decrease pain, improve fatigue, reduce anxiety and promote higher quality sleep.
Because many of the signs and symptoms of fibromyalgia are similar to those of other disorders, you may see several doctors before receiving a diagnosis. Your family physician may refer you to a doctor who specializes in the treatment of arthritis and other similar conditions (rheumatologist).
Before your appointment, you may want to write a list that includes:
In addition to doing a physical exam, your doctor will probably ask you if you have problems sleeping and if you've been feeling depressed or anxious.
April 29th, 2021