Have you ever seen a healthy adolescent or young teen that has considerable, obscure and inexplicable pains in various parts of their body?  Amplified Musculoskeletal Pain Syndrome (AMPS) is becoming more and more prevalent. This sort of symptom presentation can be confusing and potentially frightening for both the child and the parent.  The good news is that these symptoms are often indications of various imbalances that can be corrected with specialized physical therapy and behavioral therapy.  The bad news is that there are very few practitioners that are adept at treating it…but that is starting to improve.

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What is AMPS?*

  • Very painful medical condition causing pain in various parts of the body.
  • Intermittent or constant pain.
  • Localized to one region of the body or in multiple locations.
  • Pain is much greater than what might normally expected
  • Over activation of the Sympathetic Nervous System causing abnormal nerve, muscular, vascular, hormonal and immune system responses that create pain.

How To Recognize AMPS:*

  • Various pains in the body (joints and/or muscles) with or without traumatic injury or surgery.
  • Often seen with high achieving adolescents and teens.
  • Maybe associated with recent illness or bodily inflammatory processes.
  • Often associated with underlying emotional stress (anxiety, depression). 
  • Sensitivity to light touch or pressure to the extremities that would not usually cause pain
  • Abnormal pain in multiple areas of the body with exercise or sport.
  • Often confused with Rheumatoid Arthritis (RA) or autoimmune disease processes.
  • May be associated with those who have RA.

Types of AMPS:*

  • Diffuse Amplified pain – total body. 
  • Intermittent amplified pain.  Symptoms onset at various and, seemingly, random times.
  • Complex Regional Pain Syndrome (CRPS) with visible autonomic changes (color changes, extreme temperature changes, swelling, sweating, excessive hair or nail growth).
  • Allodynia or Hyperalgesia – Localized amplified pain without visible autonomic changes.

AMPS

Physical Therapy Treatment of AMPS:**

  • Thorough Medical work-up to rule out urgent disease processes.
  • Collaboration with other involved health care practitioners.
  • Education:  Learn the basics about how the nervous system can cause extreme pain even when nothing is apparently wrong.
  • Thorough physical therapy exam to determine need for the following:
    • Graded Exposure to exercise and activity – Gradual Progression of cardiovascular and strength exercise to desensitize the body.
    • Biomechanical corrective exercise – Exercises that create improved postural balance in order to decrease muscular strain.
    • Trigger Point Release as needed
    • Functional Synergistic Muscular Activation – Exercises to help build an optimized balance of muscular tone.
    • Balancing Breath Techniques – (ie. Progressive Muscle Relaxation)
    • Cognitive Functional Therapy – A technique that combines the use of thought and breath control with motion progression to normalize comfort with challenging activities.
    • Graded Motor Imagery
    • Desensitization activities

In Summary

Physical Therapy care for AMPS and other chronic pain conditions requires an approach that is not yet common in today’s medical system.  The evidence has grown remarkably. More and more practitioners are learning to shift treatment paradigms to better treat these type of conditions.  If seeking care for this sort of problem, ensure that you find a physical therapist who is skilled at using a biopsychosocial model of treatment.  

Lance Cross PT, MPT, OCS, CMTPTAbout The Author

Lance Cross, PT, MPT, OCS, CMTPT at One on One specializes in the treatment of chronic pain syndrome such as AMPS, Fibromyalgia, CRPS, and chronic joint and back pain.  He has been involved in research regarding chronic pain treatment and lectures to the Emory University Doctorate of Physical Therapy Program on the topic.   Lance’s unique experience, education and skills have helped him to refine a highly effective approach that is greatly benefiting those who are dealing with AMPS.  You can schedule an appointment with Lance by contacting One on One Physical Therapy, Atlanta Georgia via phone at 770-500-3848.

References

*information adapted from a presentation from Children’s Hospital of Philadelphia.  https://www.chop.edu/conditions-diseases/amplified-musculoskeletal-pain-syndrome-amps

**Information and treatment approaches described by Lance Cross, PT, MPT, OCS, CMTPT at One on One Physical Therapy.  https://onetherapy.com/people/lance-cross/