Amplified musculoskeletal pain syndrome

Amplified musculoskeletal pain is a syndrome which is a set of characteristic symptoms and signs. Essentially, the syndrome is characterized by diffuse, ongoing, daily pain associated with relatively high levels of incapability and greater care-seeking behavior. The discomfort can be in the skin (allodynia), abdomen, throat (dysphagia), headache, and joints. There can be other somatic symptoms such as, movement issues, dizziness, fatigue, stiffness, shakiness, coordination difficulty, swelling, fast heart rate, skin texture, color, or temperature changes, paresthesia, and changes in nail or hair growth. Examination Findings on examination can include factors associated with disuse including swelling; changes in skin texture, color, and temperature; changes in nail and hair growth, muscle atrophy, and radiographic osteoporosis. == Causes ==

It's not possible to discuss causes when there is no objectively verifiable pathophysiology. It's more accurate to describe when patients and clinicians might find this diagnosis appealing. Psychological trauma Psychological trauma is strongly associated with unexplained pain conceptualized as AMPS. Physical injury The combination of physical injury, such as a bone fracture or surgery, and over protectiveness and disuse can be referred to as complex regional pain syndrome, a type of AMPS that is isolated to one region of the body, such as a hand or foot. == Risk factors ==

Asthma, autoimmune diseases, arthritis, myositis, Ehlers-Danlos syndrome, rheumatologic diseases, being female. == Rationale ==

AMPS is theoretical rather than experimental. The amplified pain is conceptualized as incorrect sympathetic nervous system signals also known as the "fight or flight" nerves. This causes an involuntary response to pain, including vein constriction. This causes increased heart rate, increase in muscle tone, increased respiratory rate, and a reduce of blood flow to the muscles and bone, resulting in an increase in waste products, such as lactic acid. This buildup of waste products, as well as depletion of oxygen, results in the amplified pain associated with AMPS. == Classification ==

AMPS is classified into four different types, of which may be divided into multiple sub-types. This includes complex regional pain syndrome, diffuse idiopathic pain, intermittent amplified pain, and localized amplified pain. Diffuse idiopathic pain This type of AMPS includes full-body pain. It is also known as juvenile fibromyalgia. Intermittent amplified pain This type of AMPS refers to amplified pain that varies in intensity over time. Localized amplified pain This refers to localized amplified pain without other symptoms. This type cannot include symptoms such as swelling; skin texture, color, or temperature changes; or perspiration. Observation of these symptoms implies the diagnosis of complex regional pain syndrome. == Diagnosis ==

Because of the little awareness on AMPS, the condition is frequently not diagnosed when symptoms first present, often with multiple diagnoses of physical conditions before the diagnosis of AMPS. The condition is diagnosed through observation of various patient traits. A full overview of the patients medical history, as well as out rule of any potention physical causes, such as a bone fracture. If no physical causes are observed, a diagnosis of AMPS is likely possible. Other common steps that are taken may include bone scans to detect possible signs of reduced blood flow; magnetic resonance imaging (MRI) to detect possible edema, or muscle atrophy; Nerve testing can be used to look for pain or sensitivity issues; and X-rays can detect osteoporosis as the result of AMPS. While all of these tests can detect possible signs of AMPS, better outcomes are usually made with less tests, and immediate treatment of AMPS without looking for possible differential diagnoses. == Management ==

As AMPS is not a disease, there is no one specific cure for it. Many providers also use an injectable medication for treatment of AMPS. Opioid use is not recommended for most AMPS cases, as it can worsen recovery, and in rare cases, make the condition worse. Physical therapy Physical treatment of AMPS is very common and is shown to have long term benefit. This includes physical therapy, massage therapy, and aerobic exercise. Physical therapy involves training the use of the affected limb or training the use of the body. This is for the purpose of retraining muscles after muscle atrophy, and retraining how to use the affected muscles with less amplified pain. Massage therapy is used to desensitize the affected area or body so it can build a tolerance to pain. This can help with symptoms such as allodynia and hyperalgesia in AMPS, as well as indirectly help with other common symptoms by relieving the patient of pain which could have been the cause of psychological stress, depression, anxiety, as well as a number of physiological conditions, including headaches. Psychotherapy == See also ==