From the Guidelines
Amplified Musculoskeletal Pain Syndrome (AMPS) is a condition where the body's pain signals become amplified, causing severe pain disproportionate to actual tissue damage, and its management should prioritize a multidisciplinary approach focusing on physical therapy, psychological interventions, and pain management strategies.
Key Characteristics of AMPS
- Heightened pain sensitivity
- Severe pain disproportionate to actual tissue damage
- Nervous system hypersensitivity
Management of AMPS
- Physical therapy is crucial, with a gradual increase in activity to improve function and desensitize pain receptors 1
- Cognitive behavioral therapy helps patients develop coping strategies and address underlying psychological factors
- Non-opioid medications like NSAIDs may be used short-term, but long-term medication use is generally discouraged
- Heat therapy, relaxation techniques, and adequate sleep hygiene are also beneficial
Goals of Treatment
- Functional restoration rather than complete pain elimination
- Improvement in symptoms and quality of life
- Addressing underlying psychological factors and promoting coping strategies
Recent Guidelines and Recommendations
- High-quality clinical practice guidelines recommend a multidisciplinary approach to managing musculoskeletal pain, including AMPS 1
- Eleven consistent recommendations for MSK pain care have been identified, including self-management advice, education, and exercise as first-line treatments 1
- Psychological-informed management for MSK pain is an area that is currently lacking in clinical practice guidelines, but is considered important for improving outcomes 1
From the Research
Definition and Characteristics of Amplified Musculoskeletal Pain Syndrome (AMPS)
- Amplified Musculoskeletal Pain Syndrome (AMPS) is a condition characterized by increasing pain over time, allodynia, an incongruent affect, disproportional dysfunction, and the absence of other causes 2.
- It is most common in pre- to adolescent girls and may be diffuse or localized to one body part 2.
- AMPS may be associated with overt autonomic signs and psychological distress within the child or family, although it can also be associated with injury or illness 2.
Diagnosis and Treatment of AMPS
- The diagnosis of AMPS is established based on the presence of characteristic symptoms, including increasing pain, allodynia, and disproportional dysfunction 2.
- Treatment of AMPS typically involves an intense exercise program, focusing on functional aerobic training and desensitization techniques, such as towel rubbing to treat allodynia 2.
- A psychological evaluation is also recommended, and specific psychotherapy may be indicated in some cases 2.
- The average duration of the daily treatment program is 2 weeks, with a 1-hour home program to be done for another 2 to 8 weeks 2.
Outcomes and Prognosis of AMPS
- Approximately 80% of children with AMPS have no pain and are fully functional after one month of treatment, while another 15% are fully functional with mild or recurrent pain 2.
- Significant relapses are infrequent, with 15% of children requiring retreatment, and 5-10% developing a different symptom of psychological distress 2.
- At 5 years, 90% of children with AMPS are doing well, indicating a generally positive prognosis with appropriate treatment 2.