Academic journal article International Journal of Child Health and Human Development

Managing Complex Chronic Pain in Children: What to Do When Everything Fails?

Academic journal article International Journal of Child Health and Human Development

Managing Complex Chronic Pain in Children: What to Do When Everything Fails?

Article excerpt

Complex and chronic pain experiences in children are no less common than in other populations, but the expression of pain can be ambiguous, making clinical management highly subjective and challenging. While assessment tools and specific management techniques are available, the heterogeneity of cognitive and communicative function as well as the additive effects of co-morbidities make the application of standard approaches vary greatly. Even with improved knowledge of pain in children, and how pain might be influenced by differences in developmental levels, communication differences, and differences in social skills and cognition, our ability to manage pain in this population often can remain a significant challenge.

Particularly challenging is why even under ideal circumstances some children with neurodevelopmental disorders (e.g., autism, cerebral palsy) fail to achieve adequate analgesia in spite of optimal approaches to pain treatment. Why do children with irritable bowel syndrome, chronic daily headache, or complex regional pain syndrome continue to have pain even after treating them based on the commonly accepted treatments? Why do some children with cancer have chronic pain, such as children with brain tumors, children on vincristine, or survivors of childhood cancer, and how should their pain be treated? …

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