Can hypermobility increase pain in Juvenile Fibromyalgia syndrome?

Pediatric Rheumatology Online Journal, 2012, states Juvenile Fibromyalgia (JFM) is correlated with 40% of children and teenagers who also have benign hypermobility (HM). In fact, in adults hypermobility is an often seen comorbid condition.

Pediatric Rheumatology, however, undertook an observational study to see if hypermobility affects the pain experience of adolescents with juvenile fibromyalgia. It must be mentioned that juvenile fibromyalgia is a relatively new area. Often the reason it took people a decade or more to be diagnosed is that early symptoms were ignored, puzzled over, and passed on leaving the patient to continually get worse and eventually get diagnosed in their twenties if they were lucky. 

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So there has been a great deal of progress to see people acknowledging the syndrome presents far earlier than they had initially thought in many patients. In fact, there was a study done to see what the prevalence rate was for subjects who had fibromyalgia and hypermobility.

The study carried out by the Department of Pediatrics at Louisiana State University (study) had a study group of 338 students and the prevalence of JFM was 6% and of that six percent 40% had hypermobility.

The study

The study included one hundred and thirty-one JFM patients between the ages of 11 and 18.  They completed a daily visual analog scale (VAS) pain rating for a week and did the 18 tender point colorimeter assessment as well.

The results show that 48% of the sample size of JFM subjects was found to be HM+.  HM+ and HM- patients did not have any differences in their self-stated pain intensity ratings.  However, those who were HM+ had significantly greater pain sensitivity, their tender point threshold was found to be lower, and they had a larger amount of those tender points contrasted to HM- subjects.

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Conclusion

From the study, we can say that a juvenile with FM and joint hypermobility does not necessarily report more pain intensity, but that there is increased physiologic pain sensitivity.  They are looking to further study the relationship between increased pain sensitivity associated with hypermobility with juvenile fibromyalgia.

From this study, we can see a high co-occurrence of juvenile fibromyalgia with hypermobility.  As research into juvenile fibromyalgia is relatively new it will be interesting to see what comes of it. Fibromyalgia is often considered to have an onset in the thirties that increases in probability with age. Researchers still investigate and speculate about rapid-onset cases where someone develops FM after an accident or illness, but it is an entirely different matter if it develops with no trauma and in childhood. It would be interesting to see how many adult-onset people with FM have hypermobility and if the occurrence rate is far lower why it would be that developing FM at such a younger age comes with such a high incidence of hypermobility.

I had no idea about this but apparently, they have a class of fibromyalgia called Juvenile Fibromyalgia… so they are actually looking at children and teenagers and diagnosing them properly.  Would have been nice had they done that when I was younger because I was one of those people with FM that had it at a very young age and so spent a lot of time going to the doctor for blood work and tests and no answers.  Took a long time to get my diagnosis and by then it was pretty bad.  So I’m glad they have finally figured that out… not everyone gets in their thirties or older and not everyone gets it after a trauma or illness… sometimes we have the syndrome and it just slowly gets worse over time. I also have hypermobility syndrome.. that I was diagnosed with early by the way.  And it is one of the things that is comorbid with FM, a lot of us are hypermobile and apparently about 40% of JFMers are.  I wonder if it is just those who develop it as children who are more prone to having it or if it is all around common to have this co-occur and I wonder why so many of us have this… FM is in the brain and it is all about the nervous system, whereas hypermobility is the joints and connective tissue.  An interesting puzzle.

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