characteristics of the childhood pain amplification syndromes: growing pains, primary fibromyalgia, and complex regional pain syndrome.
Demographic, Clinical, and Laboratory Features of Childhood Pain SyndromesAdapted from Cassidy JT et al: Textbook of Pediatric Rheumatology, 6th ed. Philadelphia, WB Saunders, 2011.
| Growing Pains | Fibromyalgia | CRPS | |
|---|---|---|---|
| Age at onset | 4–12 years | Adolescence | Late childhood and adolescence |
| Sex ratio | Equal | Female >> male | Female >> male |
| Symptoms | Deep aching, cramping pain in thigh or calf | Fatigue | Exquisite superficial and deep pain in the distal part of an extremity |
| Usually in evening or during the night; never present in morning | Anxiety, depression | Exacerbated by passive or active movement | |
| Bilateral | Disturbed, sleep patterns | ||
| Responds to massage and analgesia | Headaches | ||
| Abdominal pain | |||
| Dizziness, paresthesias | |||
| Widespread musculoskeletal pain (>3 months) | |||
| Signs | Physical exam normal | Widespread tender points, often at characteristic sites (especially neck and back) | Diffuse swelling, tenderness, coolness and mottling of affected limb |
| Bizarre posturing of affected part | |||
| Investigations | Laboratory exam normal | Laboratory exam normal | Osteoporosis, bone scan abnormalities |
| Laboratory exam normal |
CRPS, complex regional pain syndrome.
