Chronic and Recurrent Pain in Children
Patrick J. McGrath
Department of Psychology and Pediatric Pain Research Laboratory--
IWK Grace Health Centre and Dalhousie University
Chronic pain can have a profound effect on children, spilling over into every area of a child's life and disrupting not only the child's normal activities but also the functioning of the child's family. Therefore, a comprehensive, multifaceted approach to treatment becomes important. Complete pain relief may not be realistic, but the goal must be to reduce pain to the lowest achievable level and thus permit the maintenance of a good quality of life.
In the past 10 years, great strides have been made in the recognition and better management of children's pain. In particular, physicians are more comfortable with and better equipped to measure and treat acute pain ( Shapiro, 1995; Varni & Walco, 1988). Chronic pain has not received as much attention.
Chronic pain is daunting not only for the children but also for parents and health care professionals. A working knowledge of biobehavioral aspects affecting the pain experience, the developmental process of the chronicity, and potentially effective treatments will provide a foundation to manage the majority of chronic pain problems ( Shapiro, 1995). This chapter provides an overview of the types of chronic pain, their prevalence and development, a discussion of treatments for chronic pain (pharmacological and nonpharmacological), and psychosocial considerations.
Chronic pain refers to any pain that lasts longer than the normal healing time (usually, 3 to 6 months). Recurrent pain occurs sporadically over an extended period of time. Chronic and recurrent pain can be classified