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Clinical impact and evidence base for physiotherapy in treating childhood chronic pain
Anne Ayling Campos1, Khush Amaria, Fiona Campbell
1Anne Ayling Campos, PT: Physiotherapist, Departments of Anesthesia and Pain Medicine and Rehabilitation Services, The Hospital for Sick Children, Toronto, Ontario.
Insights
Chronic pain impacts many children, necessitating an interdisciplinary approach. Physiotherapy, alongside other interventions, is crucial for managing pediatric chronic pain and enhancing function.
Area of Science:
- Pediatric Pain Management
- Adolescent Health
- Rehabilitation Medicine
Background:
- Chronic pain affects a significant number of children and adolescents.
- Specific pain conditions emerge in adolescence, disproportionately impacting girls and women.
- A biopsychosocial framework is essential for understanding and treating pediatric chronic pain.
Purpose of the Study:
- To outline the characteristics of chronic pain in children.
- To establish the rationale for interdisciplinary treatment models.
- To highlight physiotherapy's role in pain reduction and functional improvement in pediatric patients.
- To assess the evidence supporting physiotherapy for pediatric chronic neuropathic pain.
Main Methods:
- Review of existing literature and evidence.
- Analysis of cohort follow-up studies.
- Examination of retrospective chart reviews.
- Inclusion of a randomized controlled trial evaluating physiotherapy interventions.
Main Results:
- Interdisciplinary treatment programs, incorporating physiotherapy, are effective for pediatric chronic pain.
- Physiotherapy plays an integral role in improving function and reducing pain in children.
- Evidence supports physiotherapy's efficacy within a comprehensive treatment plan.
Conclusions:
- Chronic pain is a prevalent issue in pediatric populations, particularly adolescents.
- An interdisciplinary approach including physiotherapy, medication, and psychological support is recommended.
- Further research is needed to identify optimal physiotherapy modalities for specific pediatric chronic pain conditions.
Purpose:
As part of the special series on pain, our objectives are to describe the key features of chronic pain in children, present the rationale for interdisciplinary treatment, report a case study based on our biopsychosocial approach, and highlight the integral role of physiotherapy in reducing children's pain and improving function. We also evaluate the evidence base supporting physiotherapy for treating chronic neuropathic pain in children.
Summary Of Key Points:
Chronic pain affects many children and adolescents. Certain challenging pain conditions begin primarily during adolescence and disproportionately affect girls and women. Children with these conditions require an interdisciplinary treatment programme that includes physiotherapy as well as medication and/or psychological intervention. Converging lines of evidence from cohort follow-up studies, retrospective chart reviews, and one randomized controlled trial support the effectiveness of physiotherapy within an interdisciplinary programme for treating children with chronic pain.
Conclusions:
Evidence-based practice dictates that health care providers adopt clear guidelines for determining when treatments are effective and for identifying children for whom such treatments are most effective. Thus, additional well-designed trials are required to better identify the specific physiotherapy modalities that are most important in improving children's pain and function.
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