Juvenile fibromyalgia: current status of research and future developments

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.

Figure 1

Clinical features of juvenile fibromyalgia. The figure describes the clinical features of juvenile fibromyalgia, with widespread musculoskeletal pain as the central feature and many associated symptoms, including fatigue, sleep disturbance, autonomic dysregulation, cognitive difficulties and mood symptoms. Underlying pathophysiology is thought to be attributed to a complex interaction of genetic, neurobiological and environmental factors. The influence of juvenile fibromyalgia on adolescents’ lives is substantial and includes physical impairment, school absences, and difficulties with interpersonal and family functioning. Abbreviation: HPA, hypothalamic–pituitary axis.