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Management of chronic pain in children
1Section of Pediatric Anesthesiology, Yale University School of Medicine, New Haven, CT, USA.
Insights
Pediatric chronic pain often lacks organic causes, influenced by stress and external factors. Addressing pain
Area of Science:
- Pediatric Pain Management
- Child Psychology
- Behavioral Medicine
Background:
- Limited research exists on chronic pain in children compared to acute pain.
- Pediatricians must differentiate organic from non-organic causes of recurrent pain.
Purpose of the Study:
- To highlight the importance of recognizing and managing chronic pain in children.
- To emphasize the multifactorial nature of pediatric chronic pain.
Main Methods:
- Clinical assessment for organic causes.
- Evaluation of psychosocial factors, including stress and secondary gain.
- Assessment of the impact of pain on the child's life.
Main Results:
- Recurrent pain episodes may not have an identifiable organic basis.
- External and internal factors, especially perceived stress, can trigger pain.
- Pain and its relief can be influenced by rewards, secondary gain, and parental anxiety.
Conclusions:
- Chronic pain in children requires a comprehensive approach beyond excluding organic illness.
- Psychosocial factors significantly contribute to and are affected by pediatric chronic pain.
- Addressing pain's impact on self-esteem, socialization, and academics is crucial.
Abstract:
Much has been written about the recognition and treatment of acute pain, but the syndrome of chronic pain in the pediatric population has received little attention. A pediatrician faced with a child suffering from recurrent or chronic pain first should exclude an underlying organic illness. However, the clinician also should understand that recurrent painful episodes may lack an organic cause; they may be triggered by a variety of external and internal factors, particularly perceived stress. The consequences of the child's pain and its relief must be evaluated and viewed in the context of rewards, secondary gain, and parental anxiety. Chronic pain may influence self-esteem, socialization, and academic achievement, and these issues must be addressed.