The last lecture I attended at the American Academy of Pediatrics National Convention was entitled “The Achy, Tired Adolescent.” The talk was divided into 2 parts; an Adolescent Medicine Doctor discussed Chronic Fatigue Syndrome, and a Pediatric Rheumatologist discussed Fibromyalgia. No one called fibromyalgia the “F” word, which I appreciated. I was so excited to attend the talk, to hear the “Giants of Pediatrics” talk about exciting new developments. Well, there aren’t any exciting new developments. No new thoughts on the cause of these syndromes, no new information on tests for the illness, and no new ideas on treatment. Sigh. Well, at least I don’t have to change anything I do in my practice.
As the talk went on, I started to get mad. I learned that a study showed up to 6% of school aged children have fibromyalgia. Pediatricians see A LOT of school aged children, so this is a BIG NUMBER. Also, there are no systematic well controlled studies on treatment for the illness. After 30 months of the conventional therapy, 73% of children no longer meet the criteria for fibromyalgia (means they have improved). But this means that 27% are still just as sick!
25-40% of children with chronic pain fulfill the criteria for fibromyalgia, and pediatricians see A LOT of children with chronic pain.
Why wasn’t I taught this in Pediatric Residency? Think of all the patients with fibromyalgia I must have missed in 18 years, and the patients who are missed every day.
Something needs to change.