From the Guidelines
A child experiencing fatigue and myalgia should be evaluated by a pediatrician to determine the underlying cause, with common reasons including viral infections, overexertion from physical activity, or inadequate sleep, as identified in various studies 1. When assessing the child, it is essential to consider the multidimensional experience of pain, including sensory, affective, and evaluative components, as highlighted in a study on outcome measures for pediatric pain 1. The pediatrician may perform a physical exam and possibly order blood tests to rule out more serious conditions like mononucleosis or juvenile arthritis. For immediate relief, ensure the child gets plenty of rest and stays hydrated, with recommendations including:
- Offering fluids frequently
- Encouraging 10-12 hours of sleep per night
- Using over-the-counter pain relievers like acetaminophen or ibuprofen for soreness, following age-appropriate dosing instructions It is crucial to note that fatigue and soreness in children can be indicative of an underlying medical issue, such as inflammatory rheumatic and musculoskeletal diseases, which can have a significant impact on quality of life, as discussed in a study on the management of fatigue in people with these conditions 1. Therefore, if symptoms persist beyond a few days or are accompanied by fever, severe pain, or other concerning symptoms, seek medical attention promptly. Adequate sleep and hydration support the immune system and help the body heal, but persistent symptoms require professional evaluation and treatment to prevent long-term consequences, as emphasized in a practical guideline for fatigue management in inflammatory bowel disease 1.
From the Research
Causes of Fatigue and Myalgia in Children
- Fatigue in children can be caused by various factors, including lifestyle issues, underlying medical conditions, and psychological factors 2, 3
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease that can cause overwhelming fatigue, malaise, and a worsening of symptoms following minimal physical or mental exertion in children and adolescents 4
- Chronic pain in children can also contribute to fatigue and myalgia, and may be triggered by external and internal factors, such as perceived stress 5
- Fatigue in children with chronic health conditions is common and can be associated with decreased quality of life and functioning 6
Assessment and Diagnosis
- A thorough assessment is required to determine the cause of fatigue and myalgia in children, including a detailed history, physical examination, and laboratory tests 2, 4
- Diagnosis of ME/CFS is purely clinical, based on the history and exclusion of other fatiguing illnesses by physical examination and medical testing 4
- Fatigue assessment instruments can be used to evaluate fatigue in children with chronic health conditions, but the evidence for their measurement properties is limited and varies across different populations and informants 6
Management and Treatment
- Management of fatigue and myalgia in children depends on the underlying cause, and may involve lifestyle changes, medication, and other interventions 3, 4
- Successful management of ME/CFS in children and adolescents is based on determining the optimum balance of rest and activity to help prevent post-exertional symptom worsening, and may involve medications to treat pain, insomnia, and other symptoms 4