Pains and body aches could often occur in growing children. However, chronic or long-term pain is a cause for concern and may have inflammatory or neuronal underlying reasons such as arthritis, excess physical activity, growing pains, or injury. Fibromyalgia is a condition that involves chronic musculoskeletal pain syndrome (in muscles and soft tissues) and is often difficult to diagnose due to multiple unrelated symptoms (1).
This post discusses the symptoms, causes, diagnosis, and treatment options for fibromyalgia in children.
What Is Fibromyalgia?
The American College of Rheumatology describes fibromyalgia as a chronic neurologic condition that causes pain all over the body along with symptoms of fatigue, sleep disturbances, and psychological problems (2). Normal body movements and functions are affected as the child attempts to avoid pain (3).
Fibromyalgia in children and adolescents is known as juvenile fibromyalgia syndrome (JFMS) or juvenile-onset fibromyalgia. It occurs in about one to six percent of children of all ages, with an average age of 13 to 15 years. The condition is more common in girls.
What Causes Fibromyalgia In Children?
Juvenile fibromyalgia is often considered idiopathic, that is, the exact causes are still unknown. They may vary from one person to another. The following causes and risk factors may lead to fibromyalgia in children (3).
- Over sensitization to pain: Current findings describe fibromyalgia as a central pain amplification disorder, meaning that the brain becomes oversensitized (central sensitization) to pain. The person feels exaggerated, prolonged, and widespread pain for events that are not painful or slightly painful for otherwise healthy people. It is not entirely understood what causes over sensitization to pain.
- Autoimmune factors: An autoimmune disease is a condition where the body’s immune system turns against the body’s cells. Research speculates that fibromyalgia might be an early sign of an autoimmune disease. It may be that the immune system affects the central nervous system (the brain and spinal cord) and joints or muscles, leading to fibromyalgia.
- Genetics: Certain genes may be responsible for increasing the risk of fibromyalgia. The risk of a child developing fibromyalgia may be higher if they have a family history of it.
- Physical factors: These factors include spine problems, arthritis, injury, and even emotional stress, which hinder coordination of the body with the brain and spinal cord. It may increase the risk of the illness in the long run in some individuals.
- Abnormal neurotransmitters: Abnormalities in brain chemicals (neurotransmitters), such as dopamine, serotonin, and noradrenaline, may be associated with fibromyalgia symptoms in some individuals.
What Are The Symptoms Of Fibromyalgia In Children?
The major symptom of juvenile fibromyalgia syndrome is widespread body pain, which may be sharp, stabbing, tingling, sore, aching, or burning. Musculoskeletal pain starting from the back, neck, or shoulders may eventually spread throughout the body. The pain intensity may change based on physical activity, weather, and state of stress and anxiety. Many other symptoms that may differ among children and may seem unrelated are (1) (4):
- Tenderness of muscles and joints to touch or pressure
- Muscle stiffness
- Swelling in joints
- Sleep problems such as waking up and not feeling fresh
- Confusion and brain fog
- Trouble maintaining concentration
- Problem remembering things
- Irritable bowel syndrome, abdominal pain, and other gastrointestinal problems
- Numbness, tingling, and dizziness
- Blurred vision
- Cognitive and psychiatric disorders such as anxiety and depression
- Chest pain in adolescents
How Is Fibromyalgia Diagnosed?
Diagnosis of fibromyalgia is difficult as the symptoms are common with many other disorders. No specific diagnostic test is available, and it is identified by ruling out other possible illnesses, that is, through differential diagnosis.
Your clinician may perform the following procedures or steps (5).
- Assess your child’s symptoms
- Ask detailed questions about medical and family history of diseases
- Conduct imaging techniques, such as X-rays and blood tests, for ruling out other conditions
The doctor will conform to the following diagnostic guidelines to diagnose juvenile fibromyalgia syndrome.
- More than three months of widespread body pains
- Physical symptoms of fatigue, waking tired, and cognitive issues
- Total number of body areas with pain in the past week
How Is Fibromyalgia Treated In Children?
The treatment of fibromyalgia in children depends on the symptoms, age, and general health conditions. There are effective ways to manage the symptoms, but there is no cure for fibromyalgia to date.
- Physical exercise could be suggested, depending on the child’s age. Experts claim it is the most effective way to manage pain and other symptoms. Other body-based therapies, such as Tai Chi and yoga, may be beneficial. Regular low-impact aerobic exercise may also be helpful.
- Cognitive-behavioral therapy (CBT) could help improve thoughts and behaviors that affect pain and other symptoms. It may also address triggers such as sleep disorders, mood issues, anxiety, panic disorder, and depression. Mindfulness-based (non-spiritual meditation practice) stress reduction may help in managing fibromyalgia symptoms, as well. Chronic cognitive issues may require consulting a pediatric sleep specialist or psychiatrist for medication or non-medicine therapies.
- Heat and cold treatment and massage could help relax the joints and muscles, easing pain and discomfort.
- Analgesic (pain killers)or anti-inflammatory medications as per the doctor’s prescription may be considered as last resort or for cases where the pain is unbearable and interferes with the child’s lifestyle.
You should consult your child’s physician or healthcare provider before giving your child any OTC (over-the-counter) medication for fibromyalgia.
What Are The Complications Of Fibromyalgia?
Fibromyalgia could affect the quality of life in children by affecting physical functions and psychosocial development (the way your child thinks, feels, and interacts with others). The illness may have the following complications (7).
- Higher rates of rheumatic diseases, arthritis, systemic lupus erythematosus, and ankylosing spondylitis
- Higher requirement of hospitalizations than someone without fibromyalgia
- Major depression continued to adulthood
- Higher risk of suicide
Fibromyalgia in children is often benign and may resolve on its own. However, in severe cases, it may affect the child’s lifestyle, such as your child may miss school and avoid play-time activities due to pain and lack of energy. Parents can help their children manage symptoms by ensuring adherence to therapy. You may also find ways to make physical therapy and exercise fun. Provide emotional support to your child and seek medical advice whenever required (6).
- Maya Levy Coles et al. Juvenile primary Fibromyalgia Syndrome: epidemiology etiology pathogenesis clinical manifestations and diagnosis.
- de Sanctis Vincenzo et al. The juvenile fibromyalgia syndrome (JFMS): a poorly defined disorder.
- Fibromyalgia in Children.
- Fibromyalgia in Children.