Juvenile Fibromyalgia: Everything You Need to Know
Musculoskeletal disorders like fibromyalgia tend to affect older adults more often. However, these diseases are also suffered by younger populations. An example is juvenile fibromyalgia, which has a significant impact on the academic and social aspects of children.
Juvenile fibromyalgia is a disorder characterized by chronic muscle pain. It’s accompanied by other symptoms, such as fatigue and headache. Studies show that up to 6% of children can present symptoms, being more frequent between 12 and 13 years of age.
This disease can be registered in children and adolescents of both sexes, however, it’s up to 4 times more frequent in girls. Unfortunately, the disease can significantly influence lifestyle.
The main symptom of juvenile fibromyalgia is chronic pain in the skeletal muscles, which is usually highly intense referred pain. Generally speaking, referred pain experienced by children is generalized. Despite this, it’s more intense in the cervical and lumbar regions, shoulders, hips, knees, and hands.
Characteristic pain usually appears after a triggering event, such as surgery, infection, or prolonged psychological stress. It’s usually defined as a dull pain, that is, as an annoyance or heaviness. Also, the intensity of the symptom can increase with physical activity and environmental changes.
Children with juvenile fibromyalgia often have problems falling asleep and staying asleep, which can cause symptoms of different kinds. In this regard, children who suffer from the disease can also present the following manifestations:
- Constant headaches
- Chronic fatigue or lack of energy
- Joint stiffness less than 30 minutes after prolonged sleep
- Irritable bowel syndrome
- Psychiatric disorders, such as anxiety or depression
The causes of juvenile fibromyalgia
The appearance of juvenile fibromyalgia is related to various alterations in the central nervous system. They generate a wrong interpretation of pain. Studies show that these alterations appear in children who have a genetic predisposition and who are subjected to prolonged stressors.
In general terms, the alterations cause even the softest stimuli to be perceived as painful. In this way, the perception of touch, for example, is interpreted in a prolonged and generalized way.
Scientists haven’t been able to determine the specific gene that predisposes individuals to the disease. However, children with this disease have presented alterations in the promoter region of the serotonin transporter gene and in the gene for the COMT enzyme.
At the same time, external triggers can vary greatly. Accidents, sexual abuse, and school abuse are often the most common. Certain emotionally stressful situations for the child, such as parental divorce, are also responsible.
Children who meet the above conditions are more likely to develop juvenile fibromyalgia. However, the probability of occurrence is increased in girls with a family history of fibromyalgia or rheumatic disease.
How is it diagnosed?
The diagnosis of juvenile fibromyalgia is a real medical challenge, as there are no laboratory tests to confirm its presence. In this regard, a doctor should base the diagnosis on physical examination and the absence of other diseases with similar symptoms.
In spite of everything, the specialist will have to indicate the laboratory tests and imaging tests. This is done in order to rule out diseases that lead to chronic pain, such as arthritis or damage to the peripheral nerves.
One of the most important characteristics for the diagnosis of the disease is the presence of chronic pain that lasts longer than 3 months. It should increase in intensity when palpating certain characteristic points called trigger points. In addition, additional symptoms, such as fatigue, headache, and trouble concentrating, should be considered.
The criteria for the diagnosis of fibromyalgia in adults can also be applied to adolescents. These include the presence of muscle pain during the 2 weeks before the appointment, and fatigue and sleep problems during the last 3 months.
The treatment of juvenile fibromyalgia
Unfortunately, juvenile fibromyalgia is a disease with no cure. In this regard, its approach will be aimed at alleviating symptoms and adapting the child to living with the disease. Parents must make a drastic change in their lifestyle to prevent the disorder from interfering with daily activities.
Children often need a multidisciplinary approach to cope with the disease. Studies show that the combination of physiotherapy, exercises, and consultations with a psychologist helps children to recover all their functions progressively.
The performance of mild or moderate-intensity exercises has been associated with an improvement in joint mobility. In this regard, aerobic exercises between 20 and 30 minutes are recommended at least 3 days a week.
At the same time, psychological interventions and behavioral therapies can help modify the child’s response to pain. They allow the identification of triggers and help those who are affected by the disease to return to their daily activities.
The use of drugs is very controversial in juvenile fibromyalgia, as non-steroidal anti-inflammatory drugs don’t usually improve pain. The only medications recommended in these cases are anticonvulsants, such as pregabalin, and some antidepressants. However, their use must be carried out under strict prescription and medical supervision.
Ultimately, care must be taken to ensure that children get adequate sleep. Restful sleep has been associated with a significant decrease in pain.
A disease with a chronic course that warrants attention
Juvenile fibromyalgia is a disease characterized by muscle pain that lasts more than 3 months that affects children of all ages. Although it can appear at any age, it’s most common between the ages of 12 and 13.
This disease is also characterized by other symptoms, such as fatigue, depression, and anxiety, which can last for some time after the pain disappears. This causes the disease to decrease the quality of life significantly.
Unfortunately, the diagnosis is very difficult and there’s no specific treatment. However, monitoring with various health professionals can improve pain tolerance.
- Clemente Garulo D. Fibromialgia juvenil y síndrome de fatiga crónica. Protoc diagn ter pediatr. 2020;2:311-323.
- De Sanctis V, Abbasciano V, Soliman AT, Soliman N et al. The juvenile fibromyalgia syndrome (JFMS): a poorly defined disorder. Acta Biomed. 2019 Jan 23;90(1):134-148.
- Daffin M, Gibler RC, Kashikar-Zuck S. Measures of Juvenile Fibromyalgia. Arthritis Care Res (Hoboken). 2020 Oct;72 Suppl 10(Suppl 10):171-182.
- Tesher MS. Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment. Pediatr Ann. 2015 Jun;44(6):e136-41.
- Gmuca S, Sherry DD. Fibromyalgia: Treating Pain in the Juvenile Patient. Paediatr Drugs. 2017 Aug;19(4):325-338.
- Matera E, Palumbi R, Peschechera A, Petruzzelli MG et al. Juvenile Fibromyalgia and Headache Comorbidity in Children and Adolescents: A Literature Review. Pain Res Manag. 2019 Jun 3;2019:3190829.