Fibromyalgia (page 3)

Diagnosis

If your child seems to be suffering from one or more of fibromyalgia's major symptoms — such as chronic muscle pain, fatigue, or disrupted sleep — contact a doctor. While there's no specific test to diagnose fibromyalgia, a doctor can run tests to rule out other possible causes, such as thyroid disorders, infectious diseases, or rheumatic diseases (like juvenile idiopathic arthritis).

Since fibromyalgia can't be confirmed by any laboratory tests and has few, if any, visible signs, it can be difficult for doctors to diagnosis the condition. This can be frustrating for someone who has it. Some estimates claim that it takes an average of 5 years for someone with fibromyalgia to get an accurate diagnosis, and many doctors are still undereducated about the subject.

Doctors make a diagnosis of fibromyalgia in a child based on the child's medical history, his or her description of symptoms, and a check of 18 usual tender spots. Most kids with fibromyalgia will experience pain when pressure is applied to at least five of the tender spots, and will have widespread musculoskeletal aches lasting for at least 3 months. If there is no tissue swelling and conditions with similar symptoms can be ruled out, fibromyalgia might be determined to be the cause.

Treatment

Fibromyalgia can't be cured, but treatment can help manage symptoms, minimize pain, and improve a child's overall health and quality of life. Treatments for fibromyalgia include both lifestyle changes and medications.

Before trying medications, most doctors will want to start with home remedies for a child, such as:

• Regular exercise. This may increase pain at first, but exercise can help ease symptoms when done gradually and regularly. Some kids benefit from working with a physical therapist. Others can show improvement from stretching and relaxation exercises.
• Stress-relief methods. This can include yoga, t'ai chi, and other disciplines, as well as light massage, breathing exercises, and acupuncture.
• Proper sleep. Getting enough sleep is one of the most effective ways to treat fibromyalgia, so children with fibromyalgia should be encouraged to avoid caffeine and sugary beverages and snacks right before bedtime. They also should go to bed and get up at the same time each day and limit napping during the daytime.
• Healthy lifestyle choices. This includes eating a healthy diet and finding activities that help distract from the symptoms of fibromyalgia.

Some kids also find that changing the way they think about their condition helps improves their symptoms. Cognitive-behavioral therapy (CBT), a therapy administered by mental health professional, can be successful in helping kids learn to filter out negative thoughts, recognize what makes symptoms worse, and set limits to keep symptoms in check.

If these steps aren't enough to manage fibromyalgia symptoms, the doctor may prescribe medications. Some of the more common ones prescribed to treat fibromyalgia are:

• Pain relievers. Over-the-counter medications, such as acetaminophen, ibuprofen, and naproxen sodium, can help ease the pain and stiffness caused by fibromyalgia. Doctors also may use prescription pain relievers, such as tramadol.
• Antidepressants. A number of prescription antidepressants are used to ease pain and fatigue and help promote better sleep.
• Anti-seizure medications. A handful of drugs used to treat epilepsy are also useful in treating fibromyalgia symptoms.
• Sleeping aids. These allow a child to get a better night's sleep, which can relieve many of fibromyalgia's symptoms.

In addition to helping your child manage the symptoms of fibromyalgia, it's also important to provide the necessary emotional support. Talking about the condition and coming up with coping strategies together can help.

Many young people also find that support networks of their peers, as well as counseling from a trained psychologist, can help them learn to manage their symptoms, feel better, and have a more positive outlook on life.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: September 2012