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Juvenile fibromyalgia: current status of research and future developments

Nature Reviews Rheumatology volume 10, pages 89–96 (2014)Cite this article

Subjects

Key Points

  • Juvenile-onset fibromyalgia (JFM) is a complex chronic pain condition that seems to be one manifestation of a wider spectrum of chronic widespread pain syndromes in children and adolescents

  • JFM can be difficult to diagnose because of overlapping features and associated symptoms including sleep disturbance, fatigue, cognitive difficulties, headaches, abdominal pain, dysautonomia, joint hypermobility and co-occurring mood symptoms

  • JFM is associated with marked difficulties in psychosocial functioning and decreased quality of life, with symptoms tending to persist into late adolescence or early adulthood for the majority of patients

  • The pathophysiology of JFM is poorly understood and underlying factors for symptoms and pain-related impairment might include genetic, neurobiological and psychosocial influences

  • Although currently no 'cure' for JFM exists, cognitive–behavioural therapy and exercise-based interventions are promising treatments for the management of JFM symptoms and restoration of function

Abstract

Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition most commonly affecting adolescent girls. The condition is characterized by widespread musculoskeletal pain and other associated symptoms, including fatigue, nonrestorative sleep, headaches, irritable bowel symptoms, dysautonomia and mood disorders such as anxiety and/or depression. In the past few years, there has been a greater focus on understanding JFM in adolescents. Research studies have provided insight into the clinical characteristics of this condition and its effect on both short-term and long-term psychosocial and physical functioning. The importance of early and effective intervention is being recognized, as research has shown that symptoms of JFM tend to persist and do not resolve over time as was previously believed. Efforts to improve treatments for JFM are underway, and new evidence strongly points to the potential benefits of cognitive–behavioural therapy on improving mood and daily functioning. Research into pharmacotherapy and other nonpharmacological options is in progress. Advancements in the understanding of adult fibromyalgia have paved the way for future studies on diagnosis, assessment and management of JFM. This Review focuses on our current knowledge of the condition, provides an update of the latest research advances, and highlights areas for further study.

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Figure 1: Clinical features of juvenile fibromyalgia.

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Acknowledgements

S. Kashikar-Zuck acknowledges a midcareer investigator NIH grant NIAMS K24 AR056687.

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Authors and Affiliations

  1. Division of Behavioural Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Centre, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, 45229, OH, USA

    Susmita Kashikar-Zuck

  2. Division of Paediatric Rheumatology, Cincinnati Children's Hospital Medical Centre, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, 45229, OH, USA

    Tracy V. Ting

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  1. Susmita Kashikar-Zuck
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  2. Tracy V. Ting
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S. Kashikar-Zuck and T. V. Ting took joint responsibility for researching data for the article, discussion of content, writing, review and/or editing the manuscript before submission.

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Correspondence to Susmita Kashikar-Zuck.

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Kashikar-Zuck, S., Ting, T. Juvenile fibromyalgia: current status of research and future developments. Nat Rev Rheumatol 10, 89–96 (2014). https://doi.org/10.1038/nrrheum.2013.177

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