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Children 2016, 3(4), 42; doi:10.3390/children3040042

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

1
Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA
2
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA
3
Georgetown University Medical Center, Washington, DC 20057, USA
4
Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN 55455, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Carl L. von Baeyer
Received: 31 August 2016 / Revised: 26 November 2016 / Accepted: 1 December 2016 / Published: 10 December 2016
(This article belongs to the Special Issue Chronic and Recurrent Pain)
View Full-Text   |   Download PDF [293 KB, uploaded 14 December 2016]

Abstract

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 (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy. View Full-Text
Keywords: chronic pain; interdisciplinary treatment; children; adolescents; biopsychosocial; primary pain disorder; pediatric pain clinic chronic pain; interdisciplinary treatment; children; adolescents; biopsychosocial; primary pain disorder; pediatric pain clinic
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Friedrichsdorf, S.J.; Giordano, J.; Desai Dakoji, K.; Warmuth, A.; Daughtry, C.; Schulz, C.A. Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints. Children 2016, 3, 42.

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