Fibromyalgia in children

It can be particularly difficult to diagnose fibromyalgia in a child. One reason is thatsymptoms may be overlooked among the many changes that take place, both mentally and physically, as a child is growing up. Also, a child will oftenover-compensate when slowed down by an illness.

A young child is unlikely to be able to explain how they feel and questions developed especially for the young may be used by the doctor to discover how badly a child is affected.
Teenagers are often easier to diagnose as they are older and more able to describe their symptoms. Fibromyalgia often occurs after a viral illness, but it can be triggered by other factors such as an accident or shock. The doctor will discuss the medical history of the child and will probably carry out a physical examination.

Fibromyalgia is diagnosed the same way as in adults, and has the same collection of associated symptoms. Fibromyalgia is not the type of illness that will just run itscourse and fade away in a week or two. Unlike many childhood illnesses, fibromyalgia is a long lasting condition.

At present there is no cure, therefore it must be managed in a way that allows a child to live a full and productive life. With careful consideration of circumstances and team work, this can be achieved.

Why Insist on a Diagnosis?
If an illness is not identified, a child may be suspected of laziness, school phobia or of faking an illness to get attention. As a parent you may be accused of keeping your child away from school without good reason.You know better than anyone else if your child is faking an illness. A child that is too tired to play with friends or eat their favourite food is not faking.

With a diagnosis a parent or other care-giver can counter any such notions.You may have a child who has displayed a confusing combination of symptoms for several months, and it may have been difficult to get a diagnosis. If the main symptoms have been pain, muscle stiffness and fatigue and standard laboratory tests have proved negative, then the diagnosis is likely to be fibromyalgia.

Managing the condition
The two most common errors made by parents and care-givers are panic and over-protection. Common sense isyour strongest ally. A diagnosis of fibromyalgia does not mean life has to stop. It only needs re-arranging. A child troubled with this condition still has to grow and learn and just be a normal child.

Whether symptoms are constant or come and go, occasionally it may be hard for a child to take part in activities that wereonce easy and fun. But the child must be encouraged to carry on with as normal a life as possible.You can help by finding pastimes that can be enjoyed when physical activities are limited. Provide plenty of books, games, crafts and puzzles, and keep plenty of paper, paint and crayons handy for younger children.

For older children encourage craft projects that can be completed over a period of time with no pressure to finish. If concentration is not too much of a problem an older child can benefit from board games and Scrabble. These games can keep the brain active and strengthen problem solving skills.

Travel should not be ruled out as holidays are good fun for everybody – so do not beafraid to travel, but do not be over ambitious in your choice of destination. As with adults, break any journey up so that stretching breaks are taken regularly.

Education
It may be beneficial to make an appointment with the school to explain the difficulties experienced with the condition. Each school has one person responsible for ensuring children with special needs are catered for and any necessary special arrangements made. Early morning symptoms such as stiffness, pain and fatigue mean that your child may be unable to get ready for school and arrive on time.

It is far better to attend late than non-attendance for the whole day. If your child has a flare up suggest working at home. Teach your child to express physical needs clearly to other care-givers and teachers.

If requests are polite, they will not be regarded as impertinent. You can help with the words to use e.g. “May I have a rest? I am feeling really tired.” Or “May I please finish this tomorrow, as I can’t concentrate today?”

Rest periods during the day can improve stamina. Even ten minutes of rest occasionally, can keep pain and fatigue at manageable levels. You have to make it clear to both the child and the teacher, that such requests are not just excuses and that you will ensure that any missed work is done later. Encourage your child to develop a positive outlook by emphasising ability and not disability.

Standing back
The parents role is to teach the child to live successfully with this condition and to look after themselves. At the same time, you will have to watch that a younger child does not overdo physical activity and end up in bed for a week.

An older child should be allowed to judge what the physical costs are for their various activities. If staying up late, or going to a disco or football match causes more pain and fatigue, they will have to learn to budget their energy, so that they can make progress at school and still have some fun.

By Rae
former Admin