pediatric chronic pain Archives - Minnesota Physical Medicine Blog

We often visualize chronic pain as a condition that only affects older individuals who have suffered a traumatic injury or whose bodies have been exposed to decades of stress and degeneration. While those groups do make up the majority of the people we treat for chronic pain, they are far from the only groups we help.

Another group that accounts for millions of cases of chronic pain throughout the United States is children. These cases can be much more complex, because oftentimes it’s not normal wear and tear that has caused their chronic condition. It can be caused by a number of other factors, like significant injury, genetic and growth plate defects, or a combination of psycho-social issues.

To continue to help provide the best care to children with chronic pain, the World Health Organization recently updated their 10 best practices for treating children with chronic pain. We take a look at the new recommendations and offer our insights in today’s blog.

10 Best Practices For Treating Chronic Pain In Children

According to the World Health Organization, here are the 10 best ways that chronic pain physicians can manage and treat the condition in children:

Children with chronic pain and their families and caregivers must be cared for from a biopsychosocial perspective; pain should not be treated simply as a biomedical problem.
The biopsychosocial model of pain recognizes pain as a complex multidimensional experience that is the result of interaction among biological, psychological and social factors. Pain management thus requires a multimodal, interdisciplinary and integrated approach.
A comprehensive biopsychosocial assessment is essential to inform pain management and planning. As a component of this assessment, healthcare providers should use age-, context- and culturally appropriate tools to screen for, and monitor, pain intensity and its impact on the quality of life of the child and family.
Children with chronic pain must have a thorough evaluation of any underlying conditions and access to appropriate treatment for those conditions, in addition to appropriate interventions for the management of pain.
Children presenting with chronic pain should be assessed by healthcare providers who are skilled and experienced in the evaluation, diagnosis and management of chronic pain.
Management, whether with physical therapies, psychological or pharmacological interventions, or combinations thereof, should be tailored to the child’s health; underlying condition; developmental age; physical, language and cognitive abilities; and social and emotional needs.
Care of children with chronic pain should be child- and family-centered. That is, the child’s care should focus on family values, cultural preferences and resources available.8. Families and caregivers must receive timely and accurate information. Shared decision-making and clear communication are essential to good clinical care. Communication with patients should correspond to their cognitive, development, and language abilities.
The child and their family and caregivers should be treated in a comprehensive and integrated manner: all aspects of the child’s development and well-being must be attended to, including their cognitive, emotional and physical health. Moreover, the child’s educational, cultural and social needs and goals must be addressed as part of the care management plan.
In children with chronic pain, an interdisciplinary, multi-modal approach should be adopted which is tailored to the needs and desires of the child, family and caregivers, and to available resources. The biopsychosocial model of pain supports the use of multiple modalities to address the management of chronic pain.

To sum up these recommendations, a pain management specialist who is familiar with chronic pain in children needs to be able to assess the physical and social constructs that go into the expression of a pain condition. From there, the specialist needs to be able to effectively communicate with both the child and their families and provide solutions and ideas tailored to each, taking into account their age, education level, values, cultural needs and access to certain types of care. Pain management needs to be an ever-changing collaboration between the patient, the physician, their family and their care team.

Needless to say, treating chronic pain conditions in children is a tall task, and one that you need to trust to just the right physician. You need a physician who is going to put in the time and the effort needed to help treat the underlying cause, not just alleviate the symptoms. It’s hard work, but it’s arguably the most rewarding work in our field when you can help put an end to a child’s pain. Dr. Cohn has extensive experience doing this for children with a range of chronic pain conditions, and he’d like to help your child find a solution to their pain.

For more information, or for assistance in treating your child’s pain condition, reach out to Dr. Cohn’s office today.

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