Overview
Pediatric Amplified Musculoskeletal Pain Syndrome (AMPS) is a chronic, severe pain condition that may occur after a trauma or injury. The pain can be in one part of the body or may be in the entire body. The cause is not known, but it is thought to be due to a nerve problem. The pain nerves tell the brain that things like a light touch, which is normally not painful, is very painful.
Symptoms
Symptoms of AMPS include extreme pain that lasts for a long time, longer than one would expect after an injury. AMPS often develops after a mild injury, such as a sprain or other soft tissue injury. AMPS can sometimes start following a fracture or surgical procedure. There may also be swelling and changes in skin temperature, color, and dryness. These symptoms can be mild or severe.
Pediatric AMPS is more common in girls and tends to affect the lower extremity more often than the upper extremity. Children with AMPS may have pain all of the time, even when they are not moving. Movement makes the pain worse. Even light touch to the skin can cause pain. Because of the pain, patients may not want to use the affected limb and will develop weakness or muscle atrophy.
Stress and anxiety can often cause AMPS. This can include school-related stress or major life events. Illness can also trigger AMPS.
Evaluation & Examination
There is no single test to confirm the diagnosis of AMPS. Diagnosis is usually made from a careful history and physical exam, including a careful examination of the nerves. There are some tests that your doctor may order to look for other causes of pain, such as X-ray, blood work, MRI, bone scan, or nerve tests.
Treatment
Physical therapy is the main treatment for AMPS. Often it involves gradual increase in exercise, all the way up to intense exercise programs. Because normal touch is often painful in children with AMPS, desensitization (getting used to the feeling of touch on the affected limb) and massage therapy are also important.
Psychological therapy is an important part of AMPS treatment. Children and teenagers with AMPS are often dealing with other stress in their life. This therapy often helps the patient and family deal with these stressors. This has been shown in some studies to help people with chronic pain.
Medication may be a part of treatment for AMPS. Medication may be used to decrease nerve sensitivity.
Invasive treatments such as nerve blocks can also be part of treatment for pediatric AMPS. A pain management doctor often provides these treatments.
Prognosis
Overall, children with AMPS have gradual recovery. AMPS is a condition that families can manage and control. Sometimes the pain will resolve on its own in a few months, although there is a chance for it to return. Treatment with an experienced team of doctors and therapists can be successful.
References:
- Sherry, DAVID D. "An overview of amplified musculoskeletal pain syndromes." Journal of Rheumatology-Supplements27.58 (2000): 44-48.
- Hoffart, Cara M., and Dustin P. Wallace. "Amplified pain syndromes in children: treatment and new insights into disease pathogenesis." Current opinion in rheumatology 26.5 (2014): 592-603.
Q. What is Pediatric Amplified Musculoskeletal Pain Syndrome?
Pediatric Amplified Musculoskeletal Pain Syndrome (AMPS) is a chronic, severe pain condition that may occur after a trauma or injury. The pain can be in one part of the body or may be in the entire body. The cause is not known, but it is thought to be due to a nerve problem. The pain nerves tell the brain that things like light touch, which is normally not painful, is very painful.
Q. What are the symptoms of AMPS?
Symptoms of AMPS include extreme pain that lasts for a long time, longer than one would expect after an injury. AMPS often develops after a mild injury, such as a sprain or other soft tissue injury. AMPS can sometimes start following a fracture or surgical procedure. There may also be swelling and changes in skin temperature, color, and dryness. These symptoms can be mild or severe.
Pediatric AMPS is more common in girls and tends to affect the lower extremity more often than the upper extremity. Children with AMPS may have pain all of the time, even when they are not moving. Movement makes the pain worse. Even light touch to the skin can cause pain. Because of the pain, patients may not want to use the affected limb and will develop weakness or muscle atrophy.
Stress and anxiety can often cause AMPS. This can include school-related stress or major life events. Illness can also trigger AMPS.
Q. How is this diagnosed?
There is no single test to confirm the diagnosis of AMPS. Diagnosis is usually made from a careful history and physical exam, including a careful examination of the nerves. There are some tests that your doctor may order to look for other causes of pain, such as X-ray, blood work, MRI, bone scan, or nerve tests.
Q. How is this treated?
Physical therapy is the main treatment for AMPS. Often it involves gradual increase in exercise, all the way up to intense exercise programs. Because normal touch is often painful in children with AMPS, desensitization (getting used to the feeling of touch on the affected limb) and massage therapy are also important.
Psychological therapy is an important part of AMPS treatment. Children and teenagers with AMPS are often dealing with other stress in their life. This therapy often helps the patient and family deal with these stressors. This has been shown in some studies to help people with chronic pain.
Medication may be a part of treatment for AMPS. Medication may be used to decrease nerve sensitivity.
Invasive treatments such as nerve blocks can also be part of treatment for pediatric AMPS. A pain management doctor often provides these treatments.
Q. Does this get better?
Overall, children with AMPS have a gradual recovery. AMPS is a condition that families can manage and control. Sometimes the pain will resolve on its own in a few months, although there is a chance for it to return. Treatment with an experienced team of doctors and therapists can be successful.
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