Specialized Rehabilitation Programs for Children and Adolescents with Severe Disabling Chronic Pain: Indications, Treatment and Outcomes

Abstract

Children and adolescents with highly disabling chronic pain of high intensity and frequency are admitted to specialized pain rehabilitation programs. Some barriers to obtaining this specialized care include a lack of availability of treatment centers, a perceived social stigma and individual barriers such as socioeconomic status. Specialized rehabilitation programs for severe disabling chronic pain worldwide have similarities regarding admission criteria, structure and therapeutic orientation. They differ, however, regarding their exclusion criteria and program descriptions. The short- and long-term effectiveness of some rehabilitation programs is well documented. All countries should promote the establishment of future pediatric pain centers to improve the health care of children and adolescents suffering from severe chronic pain. Standardized reporting guidelines should be developed to describe treatments and outcomes to enable comparability across treatment centers.

Somatic symptom and related disorders in children and adolescents: evaluation of a naturalistic inpatient multidisciplinary treatment

“…Our findings were consistent with those of previous studies, which demonstrated that children who were highly affected by chronic pain improved in response to inpatient treatment in regard to functional impairment, pain intensity and quality of life [ 4 , 11 , 37 , 38 ]. Although there exists strong evidence for the short-term effectiveness of inpatient treatment, research concerning the long-term outcome is rare, and tools for measuring treatment outcomes need to be standardized for better comparability [ 38 ]. A meta-analysis by Hechler and colleagues demonstrated that intensive interdisciplinary pain treatment has positive treatment effects on pain intensity, disability and depressive symptoms, though school functioning and anxiety were excluded due to the heterogeneity in the treatment outcome measures [ 4 ].…”

Chronic Pain in Children: A Look at the Referral Process to a Pediatric Pain Clinic

“…The presence of limited resources available in communities to manage children with chronic pain has been shown to be a significant barrier in several countries [19–21]. There are only two pediatric pain comprehensive programs in the Los Angeles County (population 2,325,047 according to the 2015 census) [22] which can explain the delay to access our services: the average waiting time for an evaluation at our clinic is 7 weeks.…”

The impact of a short educational movie on promoting chronic pain health literacy in school: A feasibility study

“…Some of the core aspects of the development and maintenance of chronic and recurrent pain are dysfunctional, passive coping strategies, such as inactivity and social withdrawal (Simons and Kaczynski, ). In clinical populations, pain education is an important part of chronic pain treatment (Stahlschmidt et al., ). Students who have not yet developed a severe chronic pain disorder may also benefit from education to prevent dysfunctional coping and pain chronification.…”