chronic pain management for kids Archives - Minnesota Physical Medicine Blog

I try to skim the medical news every couple of days to see what’s making waves in the field of pain management. Most of what I see has to do with a variety of topics related to musculoskeletal medicine and pain.

A lot of articles I see have limited value to my current practice, but some topics have interest because there is science that may be important if it is applied in a more broad way. Other things are interesting because they are rooted in obvious facts.

Last week, the Star Tribune had an item on cancer prevention. JAMA Oncology had an article that 63 percent of men’s cancer and 41 percent of women’s cancer was preventable. The interesting thing was that if we just lived a healthy lifestyle, a lot of cancers would not occur. The obvious is the simple stuff, like not smoking and wearing sunscreen. The other aspects are a bit tougher, like eating healthier foods, not being obese, exercising, and sleeping adequately. It is a potent reminder of how we live life significantly impacts our overall health. The best way to cure cancer is to prevent cancer in the first place.

Another article in the paper was on baby powder causing cancer. The most common cancer was ovarian, but lung cancer may also be linked. The connection to cancer is that baby powder is a very fine particulate. It is also very similar to asbestos. If these fine particles get inside the body, they can cause immune reactions and stimulate abnormal tissue growth as well as cancer. So a supposedly harmless substance we use can cause deadly problems.

Take Away Points

There is a message here from these news pieces about cancer that applies to all of us. The first is that if we work at keeping ourselves healthy, we will have less illness and medical problems. Secondly, keeping compounds that naturally do not belong in our bodies out helps prevent cancer.

Applying this logic to pain management is natural. Let’s first look at the ideology of keeping ourselves healthy to prevent chronic pain. Exercises including stretching, strengthening and aerobically conditioning the body all help prevent pain. I used to be able to do parts of a program sporadically and function fairly well. As I have aged, consistency with a well-rounded program of exercise has been essential, as skipping days does not work well for me. Getting enough quality sleep is a problem; I have not yet focused on how I will try to improve my sleep. Eating healthy has been issue, but I am slowly changing my diet, lowering my carbohydrate intake, and concentrating on protein, vegetables, fruit and some cheese. I am trying to find a diet plan that makes sense and is sustainable.

The second point of focus is not adding things into my body that may not be healthy. That means keeping my medicine intake to what is necessary to prevent illness, such as taking cholesterol medicine (I have a familial variety of high cholesterol), and asthma medicine when needed. I keep away from addictive medicines. Overall, the most important aspect of health and pain control comes down to eating right, exercise, and good sleep. There is very little magic and a lot of personal work put in on my end, and my body thanks me for it.

Pediatric chronic pain is a growing problem in the United States. According to recent statistics, 1 in 5 children between the ages of 7 and 18 report that they have weekly headaches, and nearly 1 in 10 experience regular abdominal pain. Additionally, 14 percent say they frequently deal with back pain, and four percent are plagued by musculoskeletal pain.

The biggest concern, however, may be that more children are experiencing chronic pain on a regular basis. According to research published in the journal Pediatrics, the number of children admitted to the hospital due to chronic pain rose from 143 in 2004, to 1,188 in 2010 – an increase of 831 percent. With a growing need for pediatric pain treatment, it’s no wonder that more than 30 hospitals nationwide have opened pediatric pain centers of the past few years. These centers provide children with:

Specialized care

Acupuncture sessions

Unique exercise facilities

Sleep specialists

Extensive outpatient therapy treatment

“Kids may be having more pain than in previous generations, but physicians are also more attentive to it and doing more about it,” said Dr. Navil Sethna, clinical director of the rehabilitation center at the Mayo Family Pediatric Pain Rehabilitation Center, one of the top pediatric pain centers in America. Clinics like the Mayo Family Center focus on treating difficult chronic conditions, like fibromyalgia, frequent migraines or ailments resulting from a virus or other injury.

Dr. Lonnie Zektzer, director of the children’s pain and comfort care program at Mattel Children’s Hospital ULCA, said he’s referred children to the Mayo Family Center, and those types of clinics are growing in demand.

“Such programs are becoming more of a trend because they’re so badly needed.”

Pain Management vs. Pain Cure

For many of these facilities, curing the pain is the ultimate goal, but that’s not always possible. Instead, these clinics focus on helping children manage their pain and strengthen their bodies so they experience a gradual reduction in pain over time.

“We teach them how to handle any pain that comes from getting jostled in a hallway or gym class,” said Jenna Duckworth, an occupational therapist who works at the Mayo Family Pediatric Rehabilitation Center.

Judy Gaughan, a nurse and clinical coordinator at the same facility echoed Duckworth’s sentiments, saying, “The treatment goal is to maintain and regain function, not a complete alleviation of pain.”

The center notes that nearly 90 percent of children who finish their program still experience pain symptoms, but the majority report a gradual reduction over several months as they return to normal life.

A 2012 study also shows that the center is improving chronic conditions in children without heavy reliance on painkillers. Nearly all of the 56 children admitted to the program during its first year were taking fewer prescription pain medications 10 months after discharge, the children on meds were usually on a non-addictive preventative drug, and 30 percent weren’t on pain meds at all.

Related source: Boston Globe