Treatment

Treatment for juvenile fibromyalgia may include exercise programs, counseling and medications.

Graded exercise therapy

Many children who have fibromyalgia avoid activity because they're afraid it will cause more pain. It may help to start with strength-training exercises to improve gait, posture and balance. Activities such as biking, swimming or water aerobics can be added gradually.

Counseling

Cognitive behavioral therapy is a type of talk therapy that has been well studied in the treatment of chronic pain in children. It focuses on helping them manage their pain using techniques such as relaxation-based treatments, distraction and thought stopping. These techniques can help reduce disability and depression. Combining an exercise program with cognitive behavioral therapy can provide significant benefit.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Data on the use of medications in the treatment of juvenile fibromyalgia is limited. However, drugs that have shown benefit in adults have also been used in children and are sometimes effective. Common choices include:

• Antidepressants. Duloxetine (Cymbalta, Drizalma) and milnacipran (Savella) can help ease pain and fatigue. Amitriptyline may help ease pain and promote sleep. Other antidepressants may including fluoxetine (Prozac, Sarafem, others), venlafaxine (Effexor XR) or bupropion (Wellbutrin SR, Contrave, others).
• Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin, Gralise) and pregabalin (Lyrica) are sometimes prescribed for adolescents to reduce fibromyalgia pain.