Fibromyalgia in Children

Juvenile fibromyalgia is a condition that causes chronic pain in muscles and soft tissues all over the body. It is most common in adolescent girls, with most pediatric patients diagnosed between ages 13 and 15.

While the cause is unknown, fibromyalgia tends to run in families. Juvenile fibromyalgia sometimes develops in children who have experienced a physical trauma, surgery, infection or major psychological stress, though it can begin gradually over time despite no single obvious trigger.

The combination of genetics and physical or emotional stressors (also called a "stress response") can result in a process called central sensitization of the central nervous system. In central sensitization, the nerves that signal pain become hypersensitive, and changes occur in the receptors, neurotrasmitters, and signaling pathways that make up the central nervous system.

This often causes exaggerated responses to pain. Sensations that normally do not cause pain are perceived as painful, while sensations that are typically painful are perceived as even more painful, long-lasting, and widespread.

This means that in juvenile fibromyalgia, the nervous system becomes stuck in a persistent state of heightened reactivity. The threshold for pain signals is lowered, and the patient continues to feel pain even after the initial injury or trauma has healed. While this can be a frustrating condition, it is important to remember that your child’s pain is real and can get better.


Patients with juvenile fibromyalgia experience pain, often throughout the body, that is sometimes described as a constant dull ache. The pain typically occurs on both sides of the body, above and below the waist, and several areas of the body will usually feel tender if touched.

Other symptoms include:

  • Frequent headaches
  • Fatigue and sleep problems
  • Pain or cramping in the lower abdomen
  • Swelling or numbness
  • Cognitive impairment, or feeling “foggy”
  • Depression or anxiety


Treatment focuses on assisting children in their return to normal daily functioning, reducing pain, and improving sleep.

  • Medications: The following may be recommended, as needed: over-the-counter pain relievers like acetaminophen or ibuprofen, or medication for depression depending on your child’s needs.
  • Exercise: A physical therapist can work with your child on exercises to stretch their muscles and improve cardiovascular health and fitness. It is important to complete daily exercises even when having pain, soreness, or discomfort in affected areas. Physical therapy will assist in creating a plan to engage in regular aerobic exercise to improve blood flow, improve circulatory symptoms, and improve physical function, including strength, endurance, conditioning, balance, and flexibility.
  • Mental Health: A psychologist may work with your child to treat related conditions like anxiety or depression that your child may be experiencing as a result of their pain. A psychologist may also work with your child to help them develop skills to reduce their fear of pain and help them develop coping strategies to manage pain. 

Pain Management Program at Johns Hopkins All Children's Hospital

Pain is complex and is as unique as each child we treat. Whether it is the result of an injury, a chronic illness or another cause, pain can affect all areas of life including school, mood, sleep, family life and everyday activities. The pain management program at Johns Hopkins All Children's Hospital in St. Petersburg, Florida, uses medications or procedures along with therapies such as psychotherapy, biofeedback, occupational and physical therapy solely dedicated to the management of pain. 

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