Being a parent is a difficult job. There are many things to worry about daily when your children are growing up. The challenge is creating the environment for your child to become successful and independent in the future. Furthermore, everyone else has advice on how to raise a child. When you have a child with a chronic medical condition, all these challenges are amplified. The problems associated with a child who has chronic pain may be extremely difficult.
Pain is an extremely complex condition when it is chronic. There are actual physical components to the pain, and then there are all the things that happen in the brain when the signals are perceived and translated. As a pain specialist, hopefully that is what one spends their time learning about and then using to provide care to others. The best specialists can transform scientific data into specific treatment for most of their patients. Of course, one often cannot treat everyone, and sometimes that includes yourself, family, and close friends. Having chronic pain and family with issues does give one special insight into the problems.
The first overall concern for treating any sub-acute and chronic pain is that the person is fully diagnosed. A full history is needed, and exam should correlate to the problems expressed by the patient. Then if possible, appropriate studies should confirm the diagnosis. Without a diagnosis, the best treatment approaches are hard to determine. Unfortunately, many patients who show up at my office know they have pain, but this is a symptom, and determining all the causes is the first challenge before treatment can be fully implemented. If the pain has been an ongoing issue and is chronic (over 3 to 6 months or longer), then there is often more than one problem, and often the problems are not reversible. When the problems are not reversible, then goal is developing a management strategy.
If the patient is a child, one wants to make sure that there is a correct diagnosis for all the problems present. In a child, this may be a very prolonged process, since many problems heal and can be treated. Thankfully, few medical problems result in chronic pain problems for children, as most issues tend to resolve. Pediatric specialists are essential to diagnosing and treating all the issues that can be resolved. Treatment of children is usually a team process, requiring a number of physicians and therapists working together to manage the problems.
A few children do develop conditions that cause sub-acute and chronic pain. Those that have shown up in my office are usually related to musculoskeletal problems causing joint pain, or spine pain. Orthopedic surgery consultation often is involved to determine if surgical intervention is advisable. Ongoing pain that is not surgical is an extremely tough problem to treat. Currently, if the pain is chronic, then a Pediatric Pain specialist is extremely helpful to lead the management.
In the end, helping children with chronic pain comes down to a full diagnosis and a team-based approach. No one person can heal their child’s chronic pain on their own, and working with others can help everyone better understand and treat the condition. If you child complains of frequent pain or headaches, swing into an injury center for an examination.
Thomas Cohn, MD
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