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Chronic Pain In Children

How To Handle Chronic Pain In Children

Have you ever heard the saying, “If you change the way you look at things, the things you look at change?” This is an approach that is also effective when dealing with chronic pain. Chronic pain is defined as persistent and/or recurrent pain that lasts greater than 3-6 months. In the United States, the number of pediatric patients who were admitted to a hospital as a result of chronic pain increased by 831% from 2004 to 2010.

The main reason these children are heading to the emergency room is because they are experiencing headaches, abdominal pain or musculoskeletal pain. Additional symptoms include chronic fatigue, heat/cold intolerance and may other symptoms. Some kids may be in such pain that they begin using an assistive devices as a means of mobility and start missing school. In turn, their grades can begin to slip and it may become harder to maintain their friendships.

How To Help Chronic Pain in Children:

Unfortunately, clinicians don’t always have a clear picture as to what is causing this chronic pain. As a result, theseChronic Pain in Children patients seek multiple opinions from various practitioners in hopes of finding a definitive answer to the cause of their pain. This can be especially frustrating for kids and their parents because without a definitive diagnosis, it may feel like the pain they are experiencing is psychological in nature or does not truly exist.

This is where a change in perspective is needed. More research is indicating that it is more beneficial to look at improving functionality by eliminating the disability associated from chronic pain than to first focus on eliminating pain. It is hypothesized that returning to function should be the first goal in treatment, and a decrease in pain will follow. This can only be done only after any potentially harmful cause of pain has been ruled out. Adolescents and children, along with their parents, should avoid seeking out further medical attention to find the root cause of their underlying chronic pain.

Treatment for Chronic Pain In Children:

Since chronic pain is a complex topic, treatment should be approached through multiple angles by a multidisciplinary team. Physical Therapists play an integral role in the management and treatment of pediatric chronic pain. When a child is experiencing chronic pain, their central nervous system is most likely experiencing central sensitization. This is when the nervous system is functioning at a high state of reactivity. Intense physical activity and an individualized exercise prescription given by a physical therapist can help desensitize these nerves and reduce hypersensitivity.

During this process, it is crucial to eliminate any pain behaviors to facilitate functionality. A pain behavior is anything that communicates that the child is experiencing pain such as grimacing, guarding and asking for unnecessary assistance. Drawing attention to a painful body part by wearing braces or utilizing an assistive device is another type of pain behavior. A licensed physical therapist can appropriately determine when it is safe to no longer use these devices.

Unfortunately, children aren’t the only ones who demonstrate pain behaviors. Parents can be guilty of showing pain behaviors by displaying overly protective responses to their child’s complaint of pain. Parents always want to do what is best for their child. Sometimes it is hard to avoid doing these behaviors.

Participating in a multidisciplinary approach to the treatment of chronic pain can help you and your child address all of these concerns. If your child is suffering from chronic pain, schedule a physical therapy evaluation at NSPT.

north shore pediatric therapy physical therapy

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Resources:

  1. American Pain Society. Assessment and Management of Children with Chronic Pain. 2012. Available at: http://americanpainsociety.org/uploads/get-involved/pediatric-chronic-pain-statement.pdf. Accessed October 16, 2015.
  1. Coffelt T, Bauer B, Carroll A. Inpatient Characteristics of the Child Admitted With Chronic Pain. PEDIATRICS. 2013;132(2):e422-e429. doi:10.1542/peds.2012-1739.
  1. org. Central Sensitization. 2015. Available at: http://www.instituteforchronicpain.org/understanding-chronic-pain/what-is-chronic-pain/central-sensitization. Accessed October 16, 2015.
  1. Kizilbash SJ e. Adolescent fatigue, POTS, and recovery: a guide for clinicians. – PubMed – NCBI. Ncbinlmnihgov. 2015. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24819031. Accessed October 16, 2015.
  1. Odell S, Logan D. Pediatric pain management: the multidisciplinary approach. JPR. 2013;6:785. doi:10.2147/jpr.s37434.

 

Physical Therapy Posts

10 Signs at School Suggesting a Student May Benefit from Physical Therapy

Children develop and improve their gross motor skills significantly during their early school years, between three and ten years of age. A lot of gross motor development occurs at school while playing at recess or doing activities in gym class. School offers the opportunity to recognize if a child needs extra assistance from a physical therapist in expanding or improving their gross motor skills.

Physical therapist treats child

Here are some tips for teachers that will help determine if a child would benefit from physical therapy:

  1. The child prefers to sit and play instead of run or participate in gross motor activities during recess or gym class.
  2. The child has difficulty jumping, skipping, or galloping when compared to their peers.
  3. The child has an atypical gait pattern (for example, they walk on their toes or they are “knock-kneed”)
  4. The child prefers to w-sit (with their knees bent, feet by their bottom, and bottom on the floor) instead of crossed-legged on the floor.
  5. The child frequently trips, falls, or bumps into objects.
  6. When walking up and down the stairs, the child does not alternate their feet, instead placing both feet on each step.
  7. The child is unable to kick a soccer ball.
  8. The child is unable to catch or throw a playground ball.
  9. The child runs significantly slower than his peers or has difficulty running for more than one minute.
  10. The child complains of pain or tightness in their ankles, knees, hips, or back.

If you see any of these characteristics in children at school, they may benefit from a physical therapy evaluation. Without fully developed gross motor skills, a child is going to have difficulties keeping up with their peers during recess or gym class. It will also affect their ability to participate in gross motor games and sports. Also, it is important to note that many children will exhibit the above behaviors and may or may not require physical therapy (PT) intervention therefore it is important to consult with a PT first.