[Pain and fatigue therapy in children and adolescents (SHARK): care model and initial evaluation results]

Chronic pain in children and adolescents is frequently accompanied by fatigue. When even minor physical, emotional, cognitive, or social activities lead to a disproportionately severe worsening of symptoms, classical activation-oriented components of interdisciplinary multimodal pain therapy (IMPT) may reach their limits in some cases. An adapted pain treatment combines elements of IMPT with specific strategies derived from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) management, including education, symptom-oriented activity and energy management (pacing), and the identification of individually burdensome and stabilizing factors in daily life. The aim is to reduce pain and fatigue, strengthen self-efficacy, make biopsychosocial relationships understandable, and promote an age-appropriate daily structure. Initial evaluations indicate improvements in several areas.