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Amplified Musculoskeletal Pain Syndrome

Amplified musculoskeletal pain syndrome (also known as amplified pain syndrome or juvenile pain amplification syndrome) is a childhood condition that occurs when the body responds abnormally to harmless stimuli (such as touch or pressure) and interprets them as pain.

Amplified musculoskeletal pain syndrome (AMPS) can affect a single part of the body or affect the entire body.

Types of AMPS affecting specific parts of the body include:

  • reflex sympathetic dystrophy syndrome
  • complex regional pain syndrome

AMPS that is associated with widespread or total body pain may sometimes referred to by any of these terms:

  • juvenile fibromyalgia
  • juvenile primary fibromyalgia
  • pediatric fibromyalgia

Children with AMPS do not have an underlying inflammatory condition. Rather, the sense of amplified pain is triggered by one of more of the following:

  • injury
  • illness
  • psychological stress

Pain amplification is more common in teenagers than in younger children. Girls are more affected than boys, and kids and teens who experience anxiety or depression are more likely to develop amplified pain.

What are the symptoms of amplified musculoskeletal pain syndrome?

Children with AMPS do not have obvious physical symptoms such joint swelling, fevers or rashes.

Children may complain of pain in one specific region, such as a limb, or they may have generalized pain in the muscles, joints and bones throughout the body.

If the pain is localized to an arm or leg, the child may experience color and temperature changes in the affected areas. These are known as “autonomic changes.” Many children also experience “allodynia,” an abnormal sensation of pain caused by light touch.

There can be additional symptoms, however, these can be caused by many other, unrelated conditions. These include:

  • fatigue
  • trouble sleeping
  • headache
  • abdominal pain
  • depression, anxiety or tension

How is amplified pain syndrome diagnosed?

The diagnosis is largely based on a thorough review of the patient's medical history, including both physical symptoms and psychological or emotional concerns. An physical exam may identify specific locations of pain and autonomic changes, but there will be no signs of joint inflammation. Often, a doctor will order blood tests to rule out other causes of pain.

How do you treat amplified musculoskeletal pain syndrome?

The goal of treatment is to break the pain cycle so that the child can resume a normal life. A multidisciplinary approach is taken:

  • education
  • aerobic exercise
  • physical therapy
  • desensitization therapies
  • individualized outpatient psychotherapy for coping strategies and stress management

Eliminating some medications and teaching the child techniques to improve sleep can also help.

Amplified pain should never be treated with opioids or other strong painkillers, as these medications may be addictive, and do not treat the underlying cause of the pain. In rare cases, the taking of opioids could actually heighten a patient's pain issues by causing hyperalgesia.

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