Pediatric Chronic Pain Syndromes
Pediatric Chronic Pain Syndromes
Chronic pain in children is defined as persistent or recurrent pain lasting longer than 3 months or beyond the expected period of healing, significantly affecting daily activities and developmental trajectory.
Key Points
- Prevalence: 11-38% in pediatric population
- Higher prevalence in adolescents
- More common in females
- Significant impact on school attendance, social relationships, and family dynamics
- Often associated with anxiety and depression
Types of Chronic Pain Syndromes
Primary Pain Disorders
- Complex Regional Pain Syndrome (CRPS)
- Fibromyalgia
- Primary Headache Disorders
- Functional Abdominal Pain
- Juvenile Primary Fibromyalgia Syndrome
Secondary Pain Disorders
- Post-surgical pain
- Cancer-related pain
- Inflammatory conditions
- Neuropathic pain
Mixed Pain Syndromes
- Chronic widespread pain
- Chronic overlapping pain conditions
- Multiple regional pain syndrome
Clinical Assessment
Pain Assessment Tools
- Age-appropriate pain scales
- Pain diaries
- Body pain diagrams
- Functional disability inventory
- Quality of life assessments
Comprehensive Evaluation
- Detailed pain history
- Onset and progression
- Pain characteristics
- Aggravating/alleviating factors
- Impact on daily activities
- Psychosocial assessment
- School functioning
- Family dynamics
- Peer relationships
- Mood and anxiety
- Physical examination
- Musculoskeletal examination
- Neurological examination
- Functional assessment
Red Flags
- Night pain
- Systemic symptoms
- Neurological deficits
- Significant functional decline
- Weight loss
Management Approaches
Interdisciplinary Treatment
- Medical management
- Pain medications
- Anticonvulsants for neuropathic pain
- Antidepressants
- Topical agents
- Physical therapy
- Graded exercise therapy
- Desensitization techniques
- Functional rehabilitation
- Psychological interventions
- Cognitive behavioral therapy
- Biofeedback
- Mindfulness techniques
- Relaxation training
Integrative Approaches
- Acupuncture
- Massage therapy
- Music therapy
- Art therapy
- Yoga and meditation
School Accommodations
- 504 plans or IEPs
- Modified schedules
- Rest periods
- Extended assignment times
Specific Pain Conditions
Complex Regional Pain Syndrome (CRPS)
- Clinical features
- Intense burning pain
- Allodynia and hyperalgesia
- Autonomic changes
- Motor dysfunction
- Treatment approach
- Early mobilization
- Intensive physical therapy
- Pain management
- Psychological support
Fibromyalgia
- Diagnostic criteria
- Widespread pain
- Fatigue
- Sleep disturbance
- Cognitive symptoms
- Management strategy
- Exercise programs
- Sleep hygiene
- Stress management
- Medications when indicated
Chronic Headache Disorders
- Types
- Chronic migraine
- Tension-type headache
- New daily persistent headache
- Treatment approaches
- Preventive medications
- Lifestyle modifications
- Trigger avoidance
- Stress management
