Skip to main content

Clinical Management of Musculoskeletal Pain Syndromes

  • Chapter
  • First Online:
Handbook of Pediatric Chronic Pain

Abstract

The child presenting to the general practitioner with complaints of musculoskeletal pain is common and pediatricians need to be more knowledgeable of these conditions. It presents a challenge to make the diagnosis without invasive and expensive testing. A complete physical exam is essential. Often, simple reassurance, analgesics, physical therapy, and lifestyle changes are sufficient for most complaints. More specific knowledge of the multidisciplinary approach needed to treat fibromyalgia (FM) and myofascial pain syndrome (MFPS) can be helpful.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abu-Arafeh, I., & Russel, G. (1996). Recurrent limb pain in schoolchildren. Archives of Disease in Childhood, 74, 336–339.

    Article  PubMed  CAS  Google Scholar 

  • Arnold, L. M., Hess, E. V., Hudson, J. L., et al. (2002). Randomized, placebo controlled double blind, flexible dose study of fluoxetine in the treatment of women with fibromyalgia. The American Journal of Medicine, 112, 191–197.

    Article  PubMed  CAS  Google Scholar 

  • Banic, B., Petersen-Felix, S., Andersen, O. K., et al. (2003). Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia. Pain, 107, 7–15.

    Article  Google Scholar 

  • Bell, D. S., Bell, K. M., & Cheney, P. R. (1994). Primary juvenile fibromyalgia syndrome and chronic fatigue Syndrome in adolescents. Clinical Infectious Diseases, 1, S21–S23.

    Article  Google Scholar 

  • Bengtsson, A., Henriksson, K. G., Jorfeldt, L., et al. (1986a). Primary fibromyalgia: A clinical laboratory study of 55 patients. Scandinavian Journal of Rheumatology, 15, 340–347.

    Article  PubMed  CAS  Google Scholar 

  • Bengtsson, A., Henriksson, K. G., Larsson, J., et al. (1986b). Muscle biopsy in primary fibromyalgia: Light microscopical and histochemical findings. Scandinavian Journal of Rheumatology, 15, 1–6.

    Article  PubMed  CAS  Google Scholar 

  • Bennett, R. M. (1988). A comparison of cyclobenzaprine and placebo in the management of fibrositis. Arthritis and Rheumatism, 31, 1535–1543.

    Article  PubMed  CAS  Google Scholar 

  • Bennett, R. M., Degarmo, P., & Clark, S. R. (1996). A one year double blind placebo controlled study of guafenisin in fibromyalgia [Abstract]. Arthritis and Rheumatism, 39, S2–S12.

    Article  Google Scholar 

  • Bennett, R. M., Clark, S. C., & Walczyk, J. A. (1998). Randomized double blind placebo controlled study of growth hormone in the treatment of fibromyalgia. The American Journal of Medicine, 104, 227–231.

    Article  PubMed  CAS  Google Scholar 

  • Bennett, R. M., Kamin, M., & Rosenthal, K. R. (2003). Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain. The American Journal of Medicine, 114, 537–545.

    Article  PubMed  CAS  Google Scholar 

  • Berman, B. M., Ezzo, J., Hadhazy, V., et al. (1999). Is acupuncture effective in the treatment of fibromyalgia? The Journal of Family Practice, 48(3), 213–218.

    PubMed  CAS  Google Scholar 

  • Biasi, G., Manca, S., Manganelli, S., et al. (1998). Tramadol in fibromyalgia syndrome: A controlled clinical trial versus placebo. International Journal of Clinical Pharmacology Research, 18, 13–19.

    PubMed  CAS  Google Scholar 

  • Buskila, D., Press, J., Gedalia, A., et al. (1993). Assessment of non-articular tenderness and prevalence of fibromyalgia in children. The Journal of Rheumatology, 20, 368–370.

    PubMed  CAS  Google Scholar 

  • Buskila, D., Neuman, L., Hershmaan, E., et al. (1995). Fibromyalgia syndrome in children – An outcome study. The Journal of Rheumatology, 22, 525–528.

    PubMed  CAS  Google Scholar 

  • Carette, S., McCain, G. A., Bell, D. A., et al. (1986). Evaluation of amitriptyline in primary fibrositis. Arthritis and Rheumatism, 29(5), 655–659.

    Article  PubMed  CAS  Google Scholar 

  • Caruso, I., Sarzi Puttini, I., Cazzola, M., et al. (1990). Double blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. The Journal of International Medical Research, 18, 201–209.

    PubMed  CAS  Google Scholar 

  • Chandramouli, J. (2002). What is the most effective therapy for preventing NSAID-induced gastropathy? Journal of Pain and Palliative Care Pharmacotherapy, 16(2), 23–36.

    PubMed  Google Scholar 

  • Clark, S., Tidal, E., & Bennett, R. M. (1985). A double blind cross over trial of prednisone versus placebo in the treatment of fibrositis. The Journal of Rheumatology, 12, 980–983.

    PubMed  CAS  Google Scholar 

  • Crofford, L., Russell, I. J., Mease, P., et al. (2002). Pregabalin improves pain associated with fibromyalgia syndrome in a multicenter, randomized placebo controlled monotherapy trial (abstract). Arthritis and Rheumatism, 46, S613.

    Article  Google Scholar 

  • Croft, P., Burt, J., Schollum, J., et al. (1996). More pain, more tender points: Is fibromyalgia just on end of a continuous spectrum? Annals of the Rheumatic Diseases, 55, 482–485.

    Article  PubMed  CAS  Google Scholar 

  • de Blecourt, A. C., Wolf, R. F., van Rijswik, M. H., et al. (1991). Invivo P magnetic resonance spectroscopy (MRS) of tender points in patients with primary fibromyalgia syndrome. Rheumatology International, 11, 51–54.

    Article  PubMed  Google Scholar 

  • de Inocencio, J. (1998). Musculoskeletal pain in primary pediatric care: Analysis of 1000 consecutive general pediatric clinic visits. Pediatrics, 102, 63.

    Article  Google Scholar 

  • Deluz, C., Bosia, L., Zirbs, A., et al. (1992). Electroacupuncture in fibromyalgia: Results of a controlled trial. British Medical Journal, 305, 1249–1252.

    Article  Google Scholar 

  • Evans, A. M., & Scutter, S. D. (2004). Prevalence of growing pains in young children. The Journal of Pediatrics, 145, 255–258.

    Article  PubMed  Google Scholar 

  • Feldenkrais Method. (2000). health yahoo.com/health/alternative_medicine/alternative_ther…/feldenkrais_method.

    Google Scholar 

  • Felson, D. T., & Goldenberg, D. L. (1986). The natural history of fibromyalgia. Arthritis and Rheumatism, 29, 1522–1526.

    Article  PubMed  CAS  Google Scholar 

  • Ferraccioli, G. (1987). EMG Biofeedback training in fibromyalgia syndrome. The Journal of Rheumatology, 14, 820–825.

    PubMed  CAS  Google Scholar 

  • Fricton, J. R. (1990). Myofascial pain syndrome: Characteristics and epidemiology. Advances in Pain Research and Therapy., 17, 107–127.

    Google Scholar 

  • Gerwin, R. D. (2000). Advances in the treatment of neuromuscular pain: Trigger point injection therapy for neuromuscular pain. Continuing medical education. Johns Hopkins University, pp. 12–17.

    Google Scholar 

  • Glass, D. E. (1992). Tension headache and some psychiatric aspects of headache. Headache Quarterly, Current Treatment and Research, 3, 262–269.

    Google Scholar 

  • Goldenberg, D. L. (1987). Fibromyalgia syndrome, an emerging but controversial condition. The Journal of American Medical Association, 257(20), 2782–2787. May 22/29.

    Article  CAS  Google Scholar 

  • Goldenberg, D. L., Felson, D. T., & Dinerman, H. (1986). A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis and Rheumatism, 29(11), 1371–1347.

    Article  PubMed  CAS  Google Scholar 

  • Goldenberg, D. L., Burckhardt, C., & Crofford, L. (2004). Management of fibromyalgia syndrome. The Journal of Ameriacan Medical Association, 292(19), 2388–2395.

    Article  CAS  Google Scholar 

  • Goodman, J. E., & McGrath, P. J. (1991). The epidiology of pain in children and adolescents: A review. Pain, 46, 247–264.

    Article  PubMed  CAS  Google Scholar 

  • Hadhazy, V. A., Ezzo, J., Creamer, P., et al. (2000). Mind body therapies for the treatment of fibromyalgia. a systems review. The Journal of Rheumatology, 27(12), 2911–2918.

    PubMed  CAS  Google Scholar 

  • Helms, J. M. (1995). Acupuncture energetics (pp. 19–34). Berkeley: Med Acupuncture.

    Google Scholar 

  • Henriksson, K. G. (1989). Muscle pain in neuromuscular disorders and primary fibromyalgia. Neurologija, 38, 213–221.

    PubMed  CAS  Google Scholar 

  • Kalyan-Dijilani, U. P., Kalyan-Raman, K., Yunas, M. B., et al. (1984). Muscle pathology in primary fibromyalgia syndrome: A light microscopic, histochemical and ultrastructural study. The Journal of Rheumatology, 11, 808–813.

    Google Scholar 

  • Kashikar-Zuck, S., Vaught, M. H., Goldschneider, K. R., et al. (2002). Depression, coping, and functional disability in juvenile primary fibromyalgia syndrome. The Journal of Pain, 3(5), 412–419.

    Article  PubMed  Google Scholar 

  • Kemper, K. J., Sarah, R., Silver-Highfield, E., et al. (2000). On pins and needles? Pediatric pain patients’ experience with acupuncture. Pediatrics, 105(4), 941–947.

    PubMed  CAS  Google Scholar 

  • Lund, N., Bengtsson, A., & Thorcorg, P. (1986). Muscle tissue oxygen pressure in patients with primary fibromyalgia. Scandinavian Journal of Rheumatology, 15, 165–173.

    Article  PubMed  CAS  Google Scholar 

  • Malanga, G. A., & Nadler, S. F. (1999). Non operative treatment of low back pain (review). Mayo Clinic Proceedings, 74, 1135–1148.

    Article  PubMed  CAS  Google Scholar 

  • Malleson, P. N., Al-Matar, M., & Petty, R. E. (1992). Idiopathic Musculoskeletal pain syndrome in children. The Journal of Rheumatology, 19, 1786–1789.

    PubMed  CAS  Google Scholar 

  • Mannerkorpi, K., Kroksmark, T., & Ekdahl, C. (1999). How patients with fibromyalgia experience their symptoms in everyday life. Physiotherapy Research International, 4, 100–122.

    Article  Google Scholar 

  • McCain, G. A. (1986). Role of physical fitness training in the fibrositis/fibromyalgia syndrome. The American Journal of Medicine, 81, 73–77.

    Article  PubMed  CAS  Google Scholar 

  • McCain, G. A., Bell, D. A., Mai, F. M., et al. (1988). A controlled study of the effects of a supervised ­cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis and Rheumatism, 31, 1135–1141.

    Article  PubMed  CAS  Google Scholar 

  • Melzack, R. (1989). Folk medicine and the sensory modulation of pain. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (2nd ed., pp. 897–905). London: Churchill Livingston.

    Google Scholar 

  • Micheli, L. J., & Klein, J. D. (1991). Sports injuries in children and adolescents. British Journal of Sports Medicine, 25(1), 6–9.

    Article  PubMed  CAS  Google Scholar 

  • Moldofsky, H., & Lue, F. A. (1980). The relationship of alpha and delta EEG frequencies to pain and mood in fibrositis patients treated with chlorpromazine and L-Tryptophan. Electroencephalography and Clinical Neurophysiology, 50, 71–80.

    Article  PubMed  CAS  Google Scholar 

  • Moreno-Lopez, B., Pastor, A. M., de la Cruz, R. R., et al. (1997). Dose-dependent central effects of botulinum neurotoxin type A: A pilot study in the alert behaving cat. Neurology, 48, 456–464.

    PubMed  CAS  Google Scholar 

  • Naish, J. M., & Apley, J. (1950). Growing pains, a clinical study of non-arthritic limb pain in children. Archives of Disease in Childhood, 26(126), 134–140.

    Article  Google Scholar 

  • Nicassio, P. M., Radojevic, V., Weisman, M. H., et al. (1997). A comparison of behavioral and educational interventions for fibromyalgia. The Journal of Rheumatology, 24, 2000–2007.

    PubMed  CAS  Google Scholar 

  • Nielson, W. R., Jensen, M. P., & Hill, M. L. (2000). An activity pacing scale for the chronic pain coping inventory: development in a sample of patients with fibromyalgia syndrome. Pain, 89, 111–115.

    Article  Google Scholar 

  • Oakville-Trafalger Memorial Hospital. (1992). Fibro­myalgia exercise video.

    Google Scholar 

  • Pellegrino, M. J. (1993). Fibromyalgia-managing the pain. Columbus: Anadem.

    Google Scholar 

  • Pellegrino, M. J., Waylonis, G. W., & Sommer, A. (1989). Familial occurrence of primary fibromyalgia. Archives of Physical Medicine and Rehabilitation, 70, 61–63.

    PubMed  CAS  Google Scholar 

  • Peterson, H. (1986). Growing pains. Pediatric Clinic of North America, 33, 1365–1372.

    CAS  Google Scholar 

  • Petzke, F., Clauw, D. J., Ambrose, K., et al. (2003). Increased pain sensitivity in fibromyalgia: effects of stimulus type and mode of presentation. Pain, 105, 403–413.

    Article  PubMed  Google Scholar 

  • Pomeranz, B. (1996). Scientific research into acupuncture for the relief of pain. Journal of Alternative and Complementary Medicine, 2(1), 53–60.

    Article  CAS  Google Scholar 

  • Ramsey, S. M. (1997). Holistic manual therapy techniques. Primary Care, 24, 759–786.

    Article  PubMed  CAS  Google Scholar 

  • Roizenblatt, S., Tufik, S., Goldenberg, J., et al. (1997). Juvenile fibromyalgia: Clinical and polysomnographic aspects. The Journal of Rheumatology, 24(3), 579–585.

    PubMed  CAS  Google Scholar 

  • Rosen, N. B. (1994). Physical medicine and rehabilitation in management. Bailliere’s Clinical Rheumatology, 8(4), 907.

    Google Scholar 

  • Russell, J., Kamin, M., Bennet, R. M., et al. (2000). Efficacy of Tramadol in treatment of pain in fibromyalgia. Journal of Clinical Rheumatology, 6, 250–257.

    Article  PubMed  Google Scholar 

  • Rusy, L. M. (1996). Low impact exercise workout. Milwaukee: Maxishare, Children’s Hospital of Wisconsin.

    Google Scholar 

  • Rusy, L. M., & Weisman, S. J. (2000). Complementary therapies for acute pediatric pain management. Pediatric Clinics of North America, 47(3), 589–599.

    Article  PubMed  CAS  Google Scholar 

  • Rusy, L. M., Harvey, S. A., & Beste, D. J. (1999). Pediatric fibromyalgia and dizziness: Evaluation of vestibular function. Journal of Developmental and Behavioral Pediatrics, 20(4), 211–215.

    Article  PubMed  CAS  Google Scholar 

  • Sandberg, M., Lundeberg, T., & Gerdle, B. (1999). Manual acupuncture in fibromyalgia: A long term pilot study. Journal of Musculoskeletal Pain., 73(3), 39–57.

    Article  Google Scholar 

  • Schanberg, L. E., Keefe, F. J., Lefebvre, J. C., et al. (1996). Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function and psychological distress. Arthritis Care and Research, 9(2), 89–95.

    Article  PubMed  CAS  Google Scholar 

  • Sheon, R. P., & the Goff group. (1997). Repetitive strain injury 2: Diagnostic and treatment tips on six common problems. Postgraduate Medicine, 102(88), 79–85.

    Google Scholar 

  • Singh, B. B., Berman, B. M., Hadhazy, V. A., et al. (1998). A pilot study of cognitive behavioral therapy in fibromyalgia. Alternative Therapies in Health and Medicine, 4(2), 67–70.

    PubMed  CAS  Google Scholar 

  • Smythe, H. A. (1984). Problems with the MMPI (editorial). The Journal of Rheumatology, 11, 417–418.

    PubMed  CAS  Google Scholar 

  • Smythe, H. A. (1989). Non articular rheumatism and ­psychogenic musculoskeletal syndromes. In D. J. McCarthy (Ed.), Arthritis and allied conditions: A textbook of rheumatology (pp. 1241–1254). Philadelphia: Lea & Febiger.

    Google Scholar 

  • Travell, J. G., & Simmons, D. G. (1983). Myofascial pain and dysfunction: The trigger point manual. Baltimore: Williams & Wilkins.

    Google Scholar 

  • Waylonis, G. W., & Heck, W. (1992). Fibromyalgia syndrome, new associations. American Journal of Physical Medicine & Rehabilitation, 71, 343–348.

    Article  CAS  Google Scholar 

  • Wolfe, F., Smythe, H. A., Yunus, M. B., et al. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis and Rheumatism, 33(2), 160–172.

    Article  PubMed  CAS  Google Scholar 

  • Wright, E. F., & Schiffman, E. L. (1995). Treatment alternatives for patients with masticatory myofascial pain. Journal of the American Dental Association, 126, 1030–1039.

    PubMed  CAS  Google Scholar 

  • Yunas, M. B., Masi, A. T., & Aldag, J. C. (1989). Preliminary criteria for primary fibromyalgia syndrome (PFS): Multivariate analysis of consecutive series of PFS, other pain patients, and normal subjects. Clinical and Experimental Rheumatology, 7, 63–69.

    Google Scholar 

  • Yunus, M. B., Khan, M. A., Rawlings, K. K., et al. (1999). Genetic linkage analysis of multicase families with fibromyalgia syndrome. The Journal of Rheumatology, 26(2), 408–411.

    PubMed  CAS  Google Scholar 

  • Zapata, A. L., Pantoja, A. J., Leone, C., et al. (2006). Pain and musculoskeletal pain syndromes in adolescents. The Journal of Adolescent Health, 38, 769–771.

    Article  PubMed  Google Scholar 

  • Zijstra, T. R., Barendregt, P. J., & van de Laar, M. A. (2002). Venlafexedine in fibromyalgia: results of a randomized placebo controlled double blind trial [Abstract]. Arthritis and Rheumatism, 46, S105.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lynn M. Rusy .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Rusy, L.M. (2011). Clinical Management of Musculoskeletal Pain Syndromes. In: McClain, B., Suresh, S. (eds) Handbook of Pediatric Chronic Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0350-1_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-0350-1_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0349-5

  • Online ISBN: 978-1-4419-0350-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics