![]() Treatment for children diagnosed with AMPS focuses on a return to wellness and includes aerobic exercise to increase cardiovascular tone, desensitization therapies, individualized outpatient therapy for coping strategies and stress management and as well as eliminating medications for treatment of amplified pain. Get answers to frequently asked questions about the syndrome and learn about treatment options at CHOP. Testing and diagnosis of amplified musculoskeletal pain syndrome (AMPS)ĪMPS is an often elusive and misunderstood condition. Exploring individual and family dynamics does not imply that the pain is not real or is entirely due to psychological cause.Ĭhildren with AMPS and their families can benefit from various forms of psychotherapy such as cognitive-behavior therapy (CBT) which can help the child with more immediate coping strategies to deal with the pain and dysfunction as well as identify stressors, such as school, family, and friendship, and to practice expression of feelings and emotions. Many children with AMPS and their families have been negatively affected by peers, school officials and even health care professional who have dismissed the child’s symptoms.Ĭhronic pain can also significantly affect individual and family dynamics. Stressors can be positive or negative, big or small, and can include not just events, but feelings and personality styles. Stress can be both a complicating factor and trigger for amplified pain. Other illnesses that may be the initial cause are infections such as mononucleosis, gastroenteritis or influenza. Illness is an infrequent cause of AMPS, but can be more commonly seen in conjunction with inflammatory conditions such as arthritis, tendonitis, myositis or enthesitis. The symptoms of AMPS can occur suddenly or take weeks to develop. ![]() These children have suffered a significant specific injury such as a broken bone, moderate to severe musculoskeletal injury or have developed pain after surgery. It is often a combination of these factors that lead to amplified pain. There may be other factors such as age, genetics or hormones that can also affect amplified pain. There are three major causes for amplified pain: injury, illness and psychological stress. Localized amplified pain without autonomic changes (autonomic changes include color and temperature changes - for example, cold and blue - as well as swelling and sweating.)Ĭauses of amplified musculoskeletal pain syndrome (AMPS).Complex regional pain syndrome (CRPS) with autonomic changes.Diffuse amplified pain – also called total body pain or pediatric fibromyalgia.The pain then becomes greatly “amplified” through this continuous cycle. This new pain signal also goes across the abnormal short circuit in the spinal cord and causes a further decrease in blood flow leading to more pain. It is this lack of oxygen and acid build-up that causes pain. This constriction restricts blood flow and oxygen to muscles and bone and leads to an increase in waste products such as lactic acid. These nerves cause the blood vessels to become smaller (constrict). The normal pain signal not only travels up to the brain, but also goes to the neurovascular nerves (also known as autonomic or “flight or fight” nerves) that control blood flow through the blood vessels. ![]() In AMPS, there is an abnormal short circuit in the spinal cord. The brain recognizes the signal as being painful.The signal is transferred up to the brain.The damage sends a signal through the pain nerve to the spinal cord.When that happens, the following events occur: Normally, pain is triggered in response to tissue damage such as would occur when a child steps on a tack. To understand what amplified pain is, first look at the illustration to see how pain is normally felt. Whenever it occurs, the degree of pain children with AMPS experience is more intense than one would normally expect. These episodes of pain can be intermittent or constant, can affect the whole body or be localized to one area of the body or affect just a limb. Amplified musculoskeletal pain syndrome (AMPS) is a very painful medical condition that can cause pain anywhere in the body.
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