Juvenile Fibromyalgia: A Primary Pain, or Pain Processing, Disorder

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Juvenile fibromyalgia (JFM), a chronic disorder of widespread musculoskeletal pain in combination with autonomic, sensory, and cognitive dysfunction, is responsible for considerable morbidity and impaired quality of life in affected patients and their families. Historically, fibromyalgia has been incorrectly characterized as a psychosomatic or psychogenic disorder, but new understanding of the science of pain has demonstrated unambiguously that it is an organic disorder of the pain processing system itself. This new science provides a framework for understanding the pathophysiology of fibromyalgia and for developing rational therapeutic interventions. Advances in JFM include the verification of adult criteria for diagnosis in pediatric patients and the publication of effective therapies based on cognitive and physical neuromuscular intervention. Although primarily nonpharmacologic therapy can include adjunctive medications as well. Finally, the recognition that JFM is a disorder of the central and peripheral nervous systems suggests that neurologists can be important in the care of these patients.