Fibromyalgia in Children

Who is affected

Fibromyalgia is often thought of as an adult condition, but children and teenagers can develop it too. Doctors may diagnose juvenile fibromyalgia. Some services use broader terms, such as chronic widespread pain, which does not always mean the same thing.

It is diagnosed more often in girls than boys and is more often recognised in adolescence, although younger children can be affected. Common symptoms include:

• widespread aches and pain that last for months
• tiredness that does not improve with rest
• poor or unrefreshing sleep
• headaches and stomach problems
• difficulty concentrating, sometimes called "fibro fog"
• low mood or anxiety

The pain is real, even when test results are normal.

Flare Up Analyser

Describe your current flare up and we will help you identify likely triggers and what might ease it.

Try our Flare Up Analyser free, here on this site →

Getting a diagnosis

Diagnosis can take time. Children may find it hard to describe how they feel, and pain is sometimes put down to growing pains, sports injuries or stress at school.

There is no single test. The GP will ask about the pattern of symptoms and how they affect daily life, and will examine your child. Depending on the findings, they may arrange tests or specialist assessment to check for other causes, such as anaemia, thyroid disease or juvenile idiopathic arthritis. Normal blood tests do not exclude every condition. Fibromyalgia is diagnosed from the overall clinical picture, not simply by ruling everything else out.

Older criteria relied on counting tender points. Modern assessment focuses more on how widespread the pain is, how long it has lasted and the symptoms that come with it, although approaches vary between children's services. Your GP may refer your child to a paediatrician or a paediatric rheumatology service.

Your situation may be slightly different. ask a question below ↓ and our editorial team will reply with our advice.

Treatment and support

There is no cure, but treatment can improve symptoms and daily functioning. Some young people improve substantially, while others have symptoms that continue into adulthood. Support aims to help your child take part in school, friendships and activities, not only to reduce pain.

• Gentle, regular activity: walking, swimming or stretching, built up gradually. A physiotherapist can help agree a manageable plan and adjust it if symptoms worsen. Delayed, disproportionate worsening after activity needs medical review, including consideration of ME/CFS.
• Psychological support: talking therapies such as cognitive behavioural therapy (CBT) can help with coping, pain and mood. This does not mean the pain is imagined. Support may come from a paediatric pain or rehabilitation team, or from mental health services if there are additional needs. Services vary across the UK.
• Warmth: warm baths or heat pads may ease aching muscles. Follow the instructions for heat pads, protect the skin against burns and never use them during sleep.
• Medicines: discuss these with your child's GP or specialist. Evidence in juvenile fibromyalgia is limited, and some treatments used in adults are not suitable or licensed for children. Simple painkillers often do little for fibromyalgia pain itself, so regular use should be reviewed.

Seek prompt medical advice for swollen joints, persistent fever, unexplained weight loss, weakness or difficulty walking. Do not assume every new symptom is caused by fibromyalgia.

Everyday life, sleep and school

Pacing means spreading activities across the day and week with rest breaks, rather than doing too much on good days and experiencing worse symptoms afterwards.

A regular sleep routine may help, although it may not resolve unrefreshing sleep:

• keep to the same bedtime and getting up time, including at weekends
• avoid caffeine from the middle of the afternoon, including cola, energy drinks and tea
• switch off screens for a while before bed
• keep the bedroom quiet, dark and comfortable

If sleep problems continue, ask your GP about further assessment.

Talk to the school early. Helpful adjustments include movement breaks, adapted PE, flexible deadlines, accessible seating and help with missed work. Extra time in exams depends on access arrangement rules, not on the diagnosis alone. Some children need an individual healthcare plan.

In England, the special educational needs coordinator (SENCO) can help, and the Department for Education publishes guidance on supporting pupils with medical conditions on GOV.UK. Reduced timetables should be exceptional, temporary and regularly reviewed. Arrangements differ in Scotland, Wales and Northern Ireland. In Wales, schools have additional learning needs coordinators.

For further information, the NHS website, Versus Arthritis and Fibromyalgia Action UK are useful places to start.

The Next Step

Now that you have read through the advice above, you might want to put it into practice. Our Flare Up Analyser lets you describe your current flare up and we will help you identify likely triggers and what might ease it. Try it now →