Treatments for Pediatric Fibromyalgia and Musculoskeletal Pain in Children

It's entirely natural that you might be concerned, right now, about your child's health: Hearing that he has a chronic condition like fibromyalgia can be upsetting. But you can rest assured that, at Boston Children's Hospital, your child is in good hands. Our physicians are bright, compassionate and committed to focusing on the whole child, not just his condition -- that's one reason we're frequently ranked as a top pediatric hospital in the United States.

The good news about fibromyalgia is that it's not actually harming your child's body. Treatment, therefore, isn't about “healing” your child, but rather successfully controlling the symptoms of fibromyalgia so he can get on with his life.

If your child has mild symptoms, he may need very little treatment once he understands what fibromyalgia is and how to avoid things that make his symptoms worse. If his symptoms are more severe, however, he may require a comprehensive care program that includes things like a physical therapy regimen and stress reduction techniques. Only a small percentage of children will actually need medication.

Your child's doctor will tailor a treatment plan to meet your child's needs, including some or all of the following:

  • Education: The first and often the most important step is for you and your child learn what fibromyalgia is and how best to manage it in day-to-day life.

  • Exercise:Low-impact activities like swimming and yoga have been shown to ease reduce and improve mood, as well as boost overall good health. Your child's exercise program may be part of physical therapy, which also encompasses such things as stretching techniques and applying hot or cold packs for pain relief.

  • Relaxation techniques:Learning to reduce stress through things like meditation and biofeedback can help cut down on aches and pains -- and may also ease sleep problems, depression and anxiety.

  • Complementary therapies: Some children with fibromyalgia may also get relief from therapies that fall outside the realm of conventional medicine, such as acupuncture, acupressure and massage.

  • Cognitive-behavioral therapy: This teaches ways to cope with pain on a psychological level, and also to identify the stressful triggers that make pain worse.

  • Medications: Typically the last resort in treating fibromyalgia, these may include:

  • analgesics, or painkillers, like acetaminophen (Tylenol) and tramadol (Ultram)

  • antidepressants, to improve sleep and reduce pain and anxiety, like duloxetine (Cymbalta) and fluoxetine (Prozac)

  • muscle relaxants, such as cyclobenzaprine (Flexeril and others)

  • anti-seizure drugs-- namely, gabapentin (Neurontin) and pregabalin (Lyrica), which are relatively new therapies for fibromyalgia. They've been shown to ease muscle tension and improve sleep in adult fibromyalgia patients; however, it remains to be seen how effective they are for children.

Coping and support

We understand that you may have a lot of questions when your child is diagnosed with a chronic condition like fibromyalgia. How will it affect my child's life? What do we do next? We've tried to provide some answers to those questions here, along with the reassurance that many children with fibromyalgia will see their symptoms diminish or disappear with proper treatment. But for those children and families who need additional support in dealing with fibromyalgia, Boston Children's Hospital also offers a number of resources, including:

  • Parent-to-parent connections: Want to talk with someone whose son or daughter has been treated for fibromyalgia? A number of Children's parents volunteer for special training to help the families of newly diagnosed kids. Alternatively, your child's doctor may be able to put you in touch with a mom or dad of another patient who can share their experiences with you.

  • Social work: Our Rheumatology Department includes social workers -- in both inpatient and outpatient settings -- who have assisted other families whose children have fibromyalgia. Your social worker can offer counseling and problem-solving advice on issues such as coping with your child's diagnosis; dealing with financial difficulties; and finding temporary housing near the hospital if your family is traveling to Boston from another area.

  • Coping Clinic: This program has an experienced team of pediatric psychologists, psychiatrists and other mental health professionals to help children and families deal with any extra stress that a long-term health problem can bring. Offering evaluations, short-term therapy and family counseling, the Coping Clinic staff can teach you ways to prevent or better deal with the challenges of fibromyalgia.

In addition, there are many groups that help connect and educate people across the country who have fibromyalgia.

Your doctor may be able to recommend some to you, but a good place to start is the National Fibromyalgia Association (, a nonprofit devoted to supporting people with fibromyalgia and raising awareness of the condition. NFA offers a variety of public and member-only resources, including lists of local fibromyalgia support groups, an online discussion forum for patients and a quarterly magazine, Fibromyalgia Aware.