Review abstract:

Chronic pain in children and adolescents can be difficult for a single provider to manage in a busy clinical setting. Part of this difficulty is that pediatric chronic pain not only impacts the child but also the families of these children.

In this review article, we discuss etiology and pathophysiology of chronic pain, along with variables that impact the severity of chronic pain and functional loss. We review diagnosis and management of selected chronic pain conditions in pediatric patients, including headache, low back pain, hypermobility, chronic fatigue, postural orthostatic tachycardia syndrome, abdominal pain, fibromyalgia, and complex regional pain syndrome.

For each condition, we create a road map that contains therapy prescriptions, exercise recommendations, and variables that may influence pain severity. Potential medications for these pain conditions and associated symptoms are reviewed.

A multidisciplinary approach for managing children with these conditions, including pediatric pain rehabilitation programs, is emphasized. Lastly, we discuss psychological factors and interventions for pediatric chronic pain and potential complementary and alternative natural products and interventions.

November 2015Volume 7, Issue 11, Supplement, Pages S295–S315
Managing Chronic Pain in Children and Adolescents: A Clinical Review, by Bradford W. Landry DO, Philip R. Fischer MD, Sherilyn W. Driscoll MD, Krista M. Koch DPT PCS, Cynthia Harbeck-Weber PhD LP, Kenneth J. Mack MD PhD, Robert T. Wilder MD PhD, Brent A. Bauer MD, Joline E. Brandenburg MD in PM&R , Vol 7 , Issue 11 , S295 – S315