• Chronic Pain in Children and Physical Therapy: What You Should Know

    Pediatric Physical Therapy

    Nobody wants to see a child in pain. We most often see it after an accident, injury, or during an illness, but what about when it continues and does not resolve with time or simple treatments?

    Chronic pain can be a complex biological, psychological, and social condition that needs individualized treatment. Left untreated, chronic pain in children can result in a higher risk of pain and psychological disorders later in life. Physical therapists work in collaboration with other pediatric specialists to help children understand and treat their pain, and ultimately restore their activity and quality of life to the highest possible levels.

    What Is Chronic Pain?

    Chronic pain is pain that lasts for more than 3 months. For children, chronic pain can affect their ability to be active, leading to weakness and poor endurance. It also can cause a child to withdraw from play, sports, school, or other social activities, all of which are important to a child's growth and development and, in their absence, can lead to social isolation and anxiety.

    Causes

    The most common pediatric chronic pain syndromes include:

    • Abdominal pain
    • Headaches
    • Amplified musculoskeletal pain syndrome
    • Complex regional pain syndrome
    • Widespread pain
    • Overuse syndromes
    • Skeletal defects
    • Back pain
    • Cancer
    • Rheumatoid diseases

    How Physical Therapy Can Help

    Physical therapists play a vital role in the treatment of pediatric chronic pain conditions. A physical therapist will work with you to tailor a treatment plan specific to your condition, needs, and goals, which may include manual therapy, prescribed exercise, and patient education. Goals will be individualized to each child’s life and activities, and may include:

    • Become more independent
    • Decrease pain
    • Increase participation and energy levels with sports and recreational activities, school and learning, relationships, and all play activities
    • Improve mobility and gaining independence
    • Improve posture
    • Improve quality of life
    • Improve sleep patterns
    • Move the focus away from pain and learn strategies to cope with pain that can’t be alleviated
    • Return to prior functionality
    • Renew self-esteem; build confidence
    • Reduce use of assistive devices
    • Strengthen everyday activities
    • Strengthen muscles

    Working with Families

    Families carry a lot of the stress caring for and helping children with chronic pain. Physical therapists not only set goals with the children but with the families to ensure continuity in achieving each child’s goals.

    Resources

    Collins AB. Chronic pediatric pain management: a review of multidisciplinary care and emerging topics. Curr Phys Med Rehabil Rep. 2019;7(1):30-39. Article Summary.

    Weiss JE, Stinson JN. Pediatric pain syndromes and noninflammatory musculoskeletal pain. Pediatr Clin North Am. 2018:65(4):801–826. Article Summary in PubMed.

    Rabin J, Brown M, Alexander S. Update in the treatment of chronic pain within pediatric patients. Curr Probl Pediatr Adolesc Health Care. 2017;47(7):167–172. Article Summary in PubMed.

    Friedrichsdorf SJ, Giordano J, Desai Dakoji K, Warmuth A, Daughtry C, Schulz CA.  Chronic pain in children and adolescents: diagnosis and treatment of primary pain disorders in head, abdomen, muscles and joints. Children (Basel). 2016;3(4):42. Free Article.

    Authored by the Ohio Physical Therapy Association

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