Your child is going to have illnesses, injuries and psychological stress in the future. We do not suggest avoiding activities or situations that may involve stress or injury based on the fact your child had amplified musculoskeletal pain syndrome. It is our goal that your child learns how to work through these pains early on and gains the coping skills to handle stress in a more constructive fashion.
However, if your child starts to have excessive, increasing pain you should suspect AMPS. Also, if the painful area is tender to very light touch, suspect AMPS.
Half of all children with a second flare of amplified musculoskeletal pain syndrome will say the pain feels just the same as the first time; however, half will say that it feels different. For example, AMPS may be burning and tender to touch during one flare and achy without much tenderness during a second flare. Therefore, even if the pain feels different, it still may be AMPS.
If you suspect AMPS, have your child restart his or her exercise program. If the painful area is tender to light touch, desensitize it with rubbing and massage, as instructed by your child's healthcare team. The majority of second flares occur within the first six months of the first episode. Therefore, when illness or injuries occur, be sure that the pain and disability are not out of proportion to the illness or injury.
With second episodes, we are especially concerned that underlying stressors are playing a role and need to be reassessed and, if present, treated. Formal counseling can be of great help. It is important not to reinforce the sick role. When a child is hurt or in pain, the normal response is to give sympathy and make allowances, such as not having the child make his or her bed if he or she has a broken arm.
Children with chronic pain, especially AMPS, either consciously or unconsciously, receive benefits or secondary gain. This can take the form of missing school, increased parental attention, avoiding stressful social situations, getting out of sports, dance, music lessons, etc. Even though the child may truly enjoy these activities, it is still somewhat of a relief that he or she does not have to perform.
It is important for the family to stop enabling the pain and disability. We want to remove any secondary gains or reasons for the pain to linger, in order to help children get rid of their pain as quickly as possible.
Frequently it is hard to recognize what is enabling and what is just normal caring. Sometimes having either the parents or family work with a counselor is helpful in this regard.