Practical Treatment Options For Chronic Pain In Children And Adolescents

Pain is an increasingly common symptom in children and adolescents. Once recurrent pain leads to pain-related disability that affects a child’s functional, emotional and social well-being, it is considered a chronic pain disorder. Such disorders can develop as the primary condition or be due to a well-defined underlying physical condition, such as migraine or juvenile idiopathic arthritis. Approximately 5% of the paediatric population suffers from a severe chronic pain disorder. Its treatment in childhood and adolescence is complex and needs to address a variety of biological, psychological and social influencing factors. This treatment manual describes the inpatient treatment programme of one of the world’s largest inpatient treatment facilities for chronic pain management in children and adolescents – the German Paediatric Pain Centre. The guidance provided is also applicable to outpatient pain management or day-hospital approaches. The manual examines the epidemiology, aetiology, diagnostics and treatment principles in detail, explains the criteria for inpatient treatment, and describes the structure and organisation of a tertiary treatment centre for chronic pain. It also presents therapeutic interventions, such as dealing with “Black Thoughts”, “Distraction ABC”, “Stress Day” and the “Pain Provocation Technique” with the aid of numerous examples of pain management and health care from a clinical perspective. Lastly, it discusses the special features of pain treatment for children and adolescents with comorbid psychological disorders, family difficulties or defined somatic diseases, as well as pharmacological and interventional treatment options.

This manual describes the inpatient treatment programme of one of the world's largest treatment facility for chronic pain in children--The German Paediatric Pain Centre--and the guidance provided is also applicable to outpatient pain management.

Pain is an increasingly common symptom in children and adolescents, and nearly 5% of the paediatric population now suffer from severe chronic pain conditions. This manual describes the inpatient treatment programme of one of the world’s largest treatment facility for chronic pain in children – The German Paediatric Pain Centre – and the guidance provided is also applicable to outpatient pain management. Epidemiology, aetiology, diagnostics and treatment principles are all examined in detail. Criteria for inpatient treatment are explained, and the structure and organisation of a treatment centre for chronic pain are described. Therapeutic interventions are presented with the aid of many examples of pain management and health care from clinical practice. Special features of pain therapy for children and adolescents suffering from comorbid mental disorders, family difficulties or physical complaints are also discussed.

The purpose of this text is to provide not only the science and current knowledge of pediatric pain management but a rationale for intervention. The book is ground-breaking in that it provides pearls for the recognition and management of multiple childhood chronic pain syndromes. Also, uncommon yet confounding issues such as pain management for epidermolysis bullosa are adequately addressed. Concerns unique to pediatric patients are reviewed. While there are no firm standards in pediatric chronic pain, a care plan is offered to help guide practitioners when possible. The book will consist of 24 chapters, many co-written by a physician and a psychologist. Chapter 1 covers the history of pediatric chronic pain, the advancement pediatric pain as a clinical subspecialty, development of pediatric pain clinics, and characterization of the common pain syndromes. Chapters 2-4 cover, respectively, the research on early pain exposure and neuroplasticity, theories on the common adolescent pain syndromes, and the demographics of chronic pain in children. Chapters 5-16 discuss approaches to assessment and intervention for specific pediatric and adolescent pain syndromes. Chapters 17-23 address interventional techniques such as therapeutic blocks, neurablation, implantable systems, physical therapy, complementary therapy, and pharmacology including opioid tolerance. The final chapter discusses the role of the nurse practitioner in pediatric chronic pain.

Advances over the past two decades have enabled physicians to revolutionize the manner in which they can assess and manage children’s pain. Thirty years ago it was thought that young children did not experience pain and therefore it was not necessary to treat it. Today professionals from a variety of disciplines have contributed data that have revolutionized medical perspectives. Technological advances now enable doctors to treat acute pain in fetuses, premature neonates, infants, toddlers, children, and adolescents with increasing precision and efficacy. Research highlighting the context of chronic pain has moved them away from a mind-body dichotomy and toward an integrated, holistic perspective that leads to substantial improvement in children’s adaptive functioning as well as subjective discomfort. This book covers these topics and is intended for anyone who provides medical care to children. Each chapter provides an overview of the problem, followed by a "hands on" description of relevant assessment and intervention strategies. The role of the primary care practitioner is highlighted, both as a front-line resource as well as a consumer of specialized pediatric pain treatment services. Each chapter ends with a summary and specific bullet points highlighting the most central elements, making for quick and easy reference.

Paula is 12 years old. She has been suffering from chronic abdominal pains for four years. None of the treatments she underwent has helped her. Paula has turned from a fun-loving child into a quiet, suffering girl, and Paula's parents are suffering vicariously with her. Michael Dobe and Boris Zernikow have written this book for children like her and their parents. Based on their experience with out-patient as well as in-patient pain treatment in children, they show in a comprehensive manner how children and adolescents can actively face chronic pains. Many of the tips they offer are easy to implement; they sometimes require a bit of courage and patience, but no elaborate tools. This book helps families find their way back to a regular daily routine despite the pain, back to a daily life in which there is room for laughter and a positive outlook on the future. "This extraordinarily interesting and informative book will provide lasting help for many suffering children and adolescents, and thus for their parents as well." Dr. Marianne Koch, Honorary president of Deutsche Schmerzliga e. V. (German Pain League)

All children have a right to appropriate prevention, assessment andcontrol of their pain. Managing Pain in Children is anevidence-based, practical guide to care in all areas of children'spain management, providing nurses and other health carepractitioners with the skills and expertise necessary to managechildren's pain effectively. The text first explores the relevant anatomy and physiology ofchildren, the latest policy guidelines surrounding pain managementand ethical issues involved in managing children's pain. It thengoes on to look at the various pain assessment tools available forchildren and non-drug methods of pain relief. The text then goes onto apply these pain management principles to practice in relationto acute pain, chronic pain, palliative care and the management ofprocedural pain. Each of these chapters covers the evidence base,assessment techniques, pain relieving interventions, and guidancefor best practice in both hospital and community settings. Special features: Practical and accessible, with 'best practice' points in eachchapter Written in the context of latest policy developments Provides the necessary evidence-base for care throughout With contributions from experts in the field

A panel of prominent clinician-scientists comprehensively reviews the latest developments in pediatric pain management, with special emphasis on the setting in which pain is detected and managed. The authors explore the cutting-edge of children's pain care in inpatient, outpatient, palliative care, school, and residential settings, and describe alternate approaches, including complementary and alternative medicine, pain management via the internet and information technology, and pain care in developing countries.