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Pain syndromes in children
1Division of Pediatric Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada. Malleson@interchange.ubc.ca
Insights
Pediatric rheumatologists should focus on chronic musculoskeletal pain in children, recognizing its multifactorial nature. Psychosocial factors and cognitive-behavioral therapies are key to effective pain management and reducing dysfunction.
Area of Science:
- Pediatric Rheumatology
- Pain Medicine
- Child Psychology
Background:
- Chronic or recurrent musculoskeletal pain is common in childhood.
- Recent literature highlights the multifactorial nature of pediatric pain.
- Understanding pain evaluation in children is crucial.
Purpose of the Study:
- To review recent literature on pediatric pain conditions relevant to rheumatologists.
- To emphasize musculoskeletal pain, particularly chronic or recurrent types.
- To discuss broader pain topics of general interest to rheumatologists.
Main Methods:
- Literature review of recent publications.
- Focus on musculoskeletal pain in children.
- Inclusion of articles with broader pain focus if relevant to rheumatologists.
Main Results:
- Pediatric pain is multifactorial, influenced by psychosocial factors even with organic causes.
- Cognitive-behavioral therapies show effectiveness in managing chronic childhood pain.
- Childhood back pain is increasingly recognized, linked to lifestyle factors.
Conclusions:
- Proper evaluation and management of pediatric pain are essential.
- Psychosocial factors significantly impact pain perception and dysfunction.
- Cognitive-behavioral approaches offer a promising avenue for treatment.
Abstract:
This review discusses the recent literature on pain conditions in children that should be of interest to rheumatologists. The focus of the review is therefore on musculoskeletal pains in children, particularly chronic or recurrent musculoskeletal pain. Articles that have a broader focus on pain are discussed when these are likely to be of general interest to rheumatologists. Chronic or recurrent pain in childhood is common and can be caused by a wide variety of conditions, several of which are discussed here. The importance of being able to measure pain in children has been emphasized repeatedly in the recent literature. With increased understanding of how to evaluate pain in children has come the recognition that pain in children is multifactorial and that even when there are obvious "organic" causes of the pain (such as arthritis), psychosocial factors are critical in how pain is perceived, and they influence the extent to which pain leads to dysfunction. There is also increasing evidence that cognitive-behavioral therapies are effective in managing chronic pain in children. The frequency of back pain in children is increasingly recognized, and the role of children's work and play, carrying heavy backpacks, and sitting for long periods of time at computers in causing back pain is of interest. The studies reviewed here add to an increasingly rich and informative literature on musculoskeletal and other chronic pain in children, and they help emphasize the importance of proper evaluation and management of pain in children.