LOS ANGELES -- Three-fourths of 82 adolescent girls with chronic daily headache also fulfilled diagnostic criteria for fibromyalgia, and other pain-related disorders and comorbidities were common in a screening study.
Although adults with chronic daily headache are known to be at higher risk for pain in other body regions, compared with adults without chronic daily headache, it has not been known whether this phenomenon also applies to adolescents, or to what extent.
Dr. Daniel J. Lacey screened for "central sensitization" pain comorbidities in adolescent girls with chronic daily headache seen in the chronic pain or adolescent headache clinics at a Midwestern children's hospital. He also screened for more commonly recognized comorbidities-anxiety, depression, and sleep disorders -in children with chronic headache, as well as for neck and back pain, orthostatic intolerance, dysmenorrhea, pelvic pain, and joint pain or swelling.
In all, 62 patients (75%) had more than five positive fibromyalgia syndrome tender points, although only 25 of these patients complained of chronic widespread pain (40% of screen-positive patients), he reported in a poster presentation at the meeting. In addition, 49 patients (60%) screened positive for irritable bowel disease, and 37 patients (45%) reported at least moderate neck and /or back pain. Most patients complained of significant chronic tiredness, and 12 (15%) screened positive for chronic fatigue syndrome, reported Dr. Lacey of Wright State University in Dayton, Ohio.
Almost the entire cohort had mild orthostatic intolerance, and 16 patients (19%) felt that it was disruptive. Five patients (6%) had postural orthostatic tachycardia syndrome. Although 19 patients (23%) said that anxiety and/or depression were significant issues, mothers of the patients rated these two problems as much more consequential, he said.
Nearly all patients complained of at least moderate levels of nonrestorative sleep. …