title: Recurrent pain, stress, tender points and fibromyalgia in childhood: an exploratory descriptive clinical study.
abstract: OBJECTIVE
  To study the occurrence of tender points associated with fibromyalgia and their relationship with the stress-related pattern of tender points in children with psychosomatic recurrent abdominal pain.
  
  
  METHODS
  In an exploratory descriptive study, 47 children aged 6-17 years with psychosomatic recurrent abdominal pain were examined for tender points associated with fibromyalgia and those associated with stress. The individual scores for these two types of tender point were correlated at inclusion and at follow-up after treatment.
  
  
  RESULTS
  At inclusion, all children had a score for stress tender points that was near the maximum. Eight satisfied the diagnostic criteria for fibromyalgia. The scores for stress and fibromyalgia tender points were correlated significantly at both inclusion (R = 0.42, p < 0.005) and follow-up (R = 0.74, p < 0.00005). At follow-up, the children who were free of pain had significantly lower scores for stress tender points (p < 0.001) and fibromyalgia tender points (p < 0.00001) than those who were not pain free.
  
  
  CONCLUSIONS
  Children with psychosomatic pain can have an increased risk of developing fibromyalgia. A longer duration of pain and more locations in which pain is felt might increase this risk. In patients with a favourable outcome, the scores for stress tender points and fibromyalgia tender points decreased significantly.
authors: Department of Paediatric, Karolinska University Hospital, Stockholm, Sweden. gosta.alfven@karolinska.se
authors: Gösta
authors: G
authors: Alfvén
mesh_terms: D015746:Abdominal Pain / Q000150:complications* / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000293:Adolescent; D002648:Child; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D010147:Pain Measurement; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome