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Pain syndromes, disability, and chronic disease in childhood
1Research Centre, University of British Columbia, Vancouver, Canada.
Insights
Childhood disability and chronic disease management requires physician training in multidisciplinary care. Research is needed on pain management, psychosocial factors, and treatments for chronic conditions in children.
Area of Science:
- Pediatric medicine
- Rheumatology
- Chronic illness management
Background:
- Increasing prevalence of childhood disability and chronic disease due to improved survival rates.
- Need for physician training in managing complex pediatric conditions and multidisciplinary team functioning.
- Significant healthcare costs associated with chronic illness necessitate innovative funding solutions.
Purpose of the Study:
- To highlight the importance of understanding disability and handicap in pediatric care.
- To emphasize the need for increased research into pain and its management by pediatric rheumatologists.
- To explore the potential overlap and contributing factors in conditions like reflex neurovascular dystrophy, fibromyalgia, and chronic fatigue syndrome.
Main Methods:
- Review of current understanding and challenges in pediatric chronic illness.
- Discussion of the role of psychosocial factors in chronic pain conditions.
- Examination of emerging research areas such as immunoglobulin subclass deficiencies and growth hormone treatment.
Main Results:
- Childhood disability and chronic disease are rising, requiring specialized medical training.
- Psychosocial factors likely play a significant role in conditions like fibromyalgia and chronic fatigue syndrome.
- Further research is needed to clarify the clinical relevance of immunoglobulin subclass deficiencies and the efficacy of growth hormone treatment.
Conclusions:
- Pediatric rheumatologists should increase research focus on pain and its management.
- Multidisciplinary approaches and innovative funding are crucial for managing chronic childhood conditions.
- Continued investigation into the etiology and treatment of complex pediatric chronic illnesses is essential.
Abstract:
Childhood disability and chronic disease are common, and their prevalence is increasing as children survive with conditions that were previously fatal. It is important that physicians in training learn about disability and handicap, and the functioning of multidisciplinary teams to manage these problems. Chronic ill-health is often very expensive to manage, and some serious and creative thinking about the best way to fund such health care is urgently needed. Pediatric rheumatologists are involved with the care of many children with chronic and recurrent musculoskeletal pain; however, they have not perhaps focused enough research effort on the investigation of pain and its management. Whether reflex neurovascular dystrophy, fibromyalgia, and chronic fatigue syndrome are part of a disease continuum is unclear, but it seems probable that psychosocial problems are often important contributing factors in all three conditions. Immunoglobulin subclass deficiencies are being increasingly delineated, occurring in chronic fatigue syndrome as well as many other disease states. Their clinical relevance still remains, for the most part, uncertain. Short stature occurs in many chronic illnesses, and the role of growth hormone treatment in these conditions is beginning to be investigated.