JUVENILE FIBROMYALGIA: DIAGNOSTIC CHALLENGES AND THERAPEUTIC APPROACH IN PEDIATRIC PRACTICE
Abstract
Chronic pain in children and adolescents is a prevalent condition associated with functional disability, school absenteeism, and significant psychosocial repercussions. In this context, juvenile fibromyalgia, or juvenile primary fibromyalgia syndrome (JPFS), is part of the spectrum of primary chronic pain syndromes and is characterized by persistent widespread musculoskeletal pain associated with fatigue, sleep disturbances, cognitive complaints, and emotional symptoms, resulting in a substantial impact on quality of life and social participation. Despite its clinical relevance, the syndrome often remains underdiagnosed due to the heterogeneity of its clinical presentation and its overlap with rheumatologic, neurologic, and other causes of chronic pain. The diagnosis is essentially clinical and should be based on a detailed history and physical examination, with careful exclusion of secondary conditions, avoiding excessive low-yield investigations. Current evidence indicates that the pathophysiology involves mechanisms of central sensitization and interaction between biological and psychosocial factors, reinforcing the need for an integrated therapeutic approach. The most effective management is multidisciplinary and focused on functional restoration, prioritizing pain education, progressive physical rehabilitation, and psychological interventions, while pharmacological treatment should be individualized. This narrative review synthesizes recent evidence on the definition, clinical manifestations, diagnosis, differential diagnosis, and therapeutic management of juvenile fibromyalgia, offering pediatricians a practical guide for the recognition and management of this condition in clinical practice.
Author Biographies
Médico pela Pontifícia Universidade Católica de Goiás. Residente de Pediatria pelo Hospital Regional de Taguatinga.
Médica pela Universidade Católica de Brasília. Residente de Pediatria pelo Hospital Regional de Taguatinga.
Médica pelo Centro Universitário de Mineiros. Residente de Pediatria pelo Hospital Regional de Taguatinga.
Médica pelo Centro Universitário de Brasília. Pediatra pelo Hospital Regional de Taguatinga.
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