Primary pain disorders (formerly “functional pain syndromes”) are common, under- diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics. primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining rehabilitation; integrative medicine/active mind-body techniques; psychology; and normalizing daily school attendance, sports, social life and sleep will be presented. Pain improves and generally disappears as function is restored. Opioids are not indicated for primary pain disorders, and other drugs are usually not first-line treatment with a few exceptions.
KeywordsPediatric pain clinic; Chronic pain; Interdisciplinary treatment
Published Date: 2023-02-28; Received Date: 2023-02-01
