Pain Clinic

Amplified Pain Clinic (APS)

Amplified pain syndrome (APS) is a condition in which the child’s perception of pain is increased due to the abnormal firing of nerves which sense pain and control vascular tone. Pain can be localized to one area of the body, can be generalized throughout the body, and sometimes includes other physical symptoms in addition to pain.

Common symptoms include:

APS can be triggered by stress, illness or prior injury. Your child’s pain is real, and it can get better. 

APS can include:

• Juvenile primary fibromyalgia syndrome (JPFS).
• Complex regional pain syndrome (CRPS), formerly reflex sympathetic dystrophy (RSD).
• Other types of nerve-related pain.

APS treatment

Successful treatment for children diagnosed with APS requires focusing on physical function and pushing through the discomfort to retrain the over-firing nerves and blood vessels.

Treatment includes intense exercise and desensitization therapy guided by physical and occupational therapy recommendations, decreasing attention to pain and focusing on performing normal daily activities, as well as stress management. It is important to address all aspects of APS to break the pain cycle.

Pain and associated symptoms often worsen before getting better and the ability to do normal things usually returns before pain resolves. Often, children/adolescents who have continued pain, have not fully addressed the stress component.

Four-prong approach to treatment

Please note that it is imperative to address all four aspects in order to successfully treat the pain.

Most children are able to get better on their own with these outpatient strategies. However, some children require more rigorous therapies through interdisciplinary pain rehabilitation. For those with severe disability who have failed outpatient management, we can escalate the intensity and "dosing" of exercise and stress management through the Rehabilitation for Amplified Pain Syndromes (RAPS) Program.