Juvenile Fibromyalgia

Juvenile Fibromyalgia is a chronic musculoskeletal pain in adults, adolescents as well as in children.

The related symptoms include fatigue, non-restorative sleep, headaches and mood disorders such as anxiety and/or depression.

Although the exact reason is unknown but researchers believe that central pain signal processes amplify the painful incidences.

Juvenile fibromyalgia is more prevalent in school children and almost 2-6 percent adolescent girls suffer from this disease.

The symptoms of juvenile fibromyalgia can be triggered by events like:

• physical trauma surgery,
• infection,
• significant psychological stress,

or can appear gradually without any specific reason.

The major symptoms are:

Pain: pain is the most evident symptom of fibromyalgia. A constant dull ache is experienced that can even last for three months.

In a case of children, there is a widespread diffused pain. A frequent headache in many patients is reported.

Sleeping disorders: The patient, mostly children take an hour or more to fall sleep and undergo a constant state of fatigue.

Fatigue: Many people complain about being tired even after taking a long nap. The sleep is often disturbed by pain or other sleeping disorders.

Other problems: Many other problems like cramps in the lower abdomen, depression and anxiety could be experienced.

The exact cause of juvenile fibromyalgia is not known, but a variety of factors are likely to contribute to the occurrence of the disease.

These factors may be:

• Genetic susceptibility
• Physical or emotional trauma
• Post-traumatic stress disorder

According to a research, repeated nerve stimulations trigger an abnormal increase in the level of certain chemicals in the brain which is responsible for stimulating pain.

The diagnosis of juvenile fibromyalgia may take a while.

One may have to seek more than one doctor before getting a diagnosis because the signs and symptoms are not specific and are similar to many other diseases.

For treatment of juvenile fibromyalgia, a multidisciplinary approach is used.

Thus, a panel of clinicians, psychologists, and rehabilitation specialist are involved, who prescribe a combination of therapies that include pharmacology, psychotherapy, physical intervention and patient education about the disease.

These have proved to be effective in a case of children and teens for long term treatments. The medications help in reducing pain and sleeping problems.

Drugs commonly used to treat fibromyalgia are:

Antidepressants like duloxetine (cymbalta) and milnacipran (savella) are prescribed to ease fatigue and pain whereas amitriptyline and fluoxetine (prozac) could be prescribed for promoting sleep.

Pain relievers: Some of the pain relievers used are acetaminophen, tylenol, ibuprofen, advil, motrin IB, others or naproxen sodium.

Sometimes pain relievers such as tramadol, ultram, conzip are also prescribed.

Anti-seizure drugs: The drugs that are commonly used for the treatment of epilepsy are somewhat useful in the treatment of juvenile fibromyalgia also.

These drugs include gabapentin, neurontin, gralise and pregabalin (lyrica).

Psychotherapy: This therapy is used as an adaptive coping skill that helps in managing pain.

These skills include relaxation-based treatment, distraction, activity pacing, and problem-solving and working on positive and calming appraisal.

Parents of children suffering from such condition should participate in such sessions that help them in managing and supporting their children at home.

A few alternative remedies exist for juvenile fibromyalgia.

Alternative therapies for pain and stress management are practiced since ages like meditation and yoga.

Some of these that have been accepted in mainstream medicines are mentioned below:

• Yoga and meditation: Breathing and relaxation can be practised through special yogic postures.
• Tai chi: It is an ancient Chinese technique that includes slow and rhythmic movements that enhance relaxation and calms the senses.
• Massage: Massage is one of oldest methods that include different flexible techniques to stimulate body muscles and soft tissues. Massage helps in relieving stress and anxiety by relaxing muscles, lowering the heart rate and releasing body’s natural painkillers.

The following lifestyle modifications can help in minimizing the risk of fibromyalgia:

• Stress is the root of many diseases. Thus, it is advised to limit physical and mental stress and take out some time to relax.
• Good sleep is very necessary as fatigue is the main characteristic of fibromyalgia.
• Exercise regularly as it helps the body to relax and keeps it active.
• Initially, exercise may increase your pain, but gradually it helps in decreasing the symptoms.

Self-care measures play a very important role in the management of fibromyalgia.

The person with a family history of juvenile fibromyalgia is at a greater risk of incidence of the disease.

Other diseases like arthritis, lupus or Lyme disease also increase the risk of juvenile fibromyalgia.

Pain and insomnia along with other symptoms may affect the child’s performance in school and college.

This may lead to frustration which in turn may lead to depression.