Causes of Amplified Musculoskeletal Pain Syndrome | The Children’s Hospital of Philadelphia
This is post expands upon a previous post: Have Pain? Are You Crazy?. Dr. Sherry has decided that CRPS is actually a mental disorder which he calls amplified musculoskeletal pain syndrome (AMPS). He advocates against treating the pain
There are three major causes for the abnormal reflex in children with amplified musculoskeletal pain syndrome (AMPS): injury, illness and psychological stress.
Types of injuries that lead to AMPS Injury is the cause of AMPS in approximately 10 to 20 percent of children.
ypes of illnesses that lead to AMPS Illness is an infrequent cause of amplified musculoskeletal pain syndrome. It is most commonly seen in conjunction with four inflammatory illnesses of the musculoskeletal system: arthritis, tendonitis, myositis or enthesitis. Other illnesses may be the initial cause of pain; most are infections such as mononucleosis, influenza or gastroenteritis. Constipation can also lead to amplified abdominal pain.
In at least 80 percent of children with amplified musculoskeletal pain syndrome, psychological factors seem to play a role
One major stressor we see in many children is the psychological consequence of having such severe pain. This frequently is due to others not understanding the nature of the pain (many friends, teachers and family members do not believe the pain is as intense as it is) and also having a delay in diagnosis and multiple failed therapies
Dr. Sherry seems to contradict himself repeatedly:
One major stressor we see in many children is the psychological consequence of having such severe pain. This frequently is due to others not understanding the nature of the pain.
– versus another of his statements —
The pain is very real and very intense. Even in those children for whom psychological stress is a trigger or complicating factor, the decreased blood flow to the area of AMPS causes extreme body pain.
The reasoning seems to be that pain is what’s causing the “conversion” symptoms, so why not just treat the pain?
Is AMPS all in my child’s head? No, not at all. The pain is very real and very intense. Even in those children for whom psychological stress is a trigger or complicating factor, the decreased blood flow to the area of AMPS causes extreme body pain.
Conversion symptoms occur when the subconscious emotional self causes nerve activity or inactivity. The classic example is a child who suddenly goes blind after seeing her dog get run over by a car.
It is easy to theorize about the subconscious, but making such statements as though they were proven facts is unscientific and misleading.
Conversion symptoms we commonly see include:
- Involuntary spasms of the muscles, such as a clenched fist or shaking (sometimes mistakenly called dystonia)
- Dizziness, Racing heart Fainting and lightheadedness, often called postural orthostatic tachycardia syndrome (POTS) or dysautonomia
- Non-epileptic events (or pseudo seizures)
- Shortness of breath Memory problems
- Urinary urgency or retention
- Inability to talk and visual difficulties (for example, unable to read but can see).
Some of these symptoms are evidence of a serious illness, like POTS. There is no scientific debate about this being a physical malfunction of the body, so Dr. Sherry is simply wrong.