Update in the Treatment of Chronic Pain within Pediatric Patients

Rabin, Jeffrey P.; Brown, Mackenzie; Alexander, Sean

doi:10.1016/j.cppeds.2017.06.006

Cited by 20 publications

(41 citation statements)

References 21 publications

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“…Yet current treatment options often do not, or only partly address the many lifestyle factors associated with chronic pain, or try to address two or more lifestyle factors in a standardized way. It is proposed that treatment approaches for people having chronic pain should address all relevant lifestyle factors concomitantly into an individually tailored multimodal intervention, both in pediatric and adult populations with chronic pain. Ultimately, this should decrease the psychological and socioeconomic burden of chronic pain.…”

Section: Resultsmentioning

confidence: 99%

Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth?

Nijs

D’Hondt

Clarys

et al. 2019

PM&R

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Chronic pain has a tremendous personal and socioeconomic impact and remains difficult to treat. Therefore, it is important to provide an update on the current understanding regarding lifestyle factors in people with chronic pain across the lifespan. Lifestyle factors such as physical (in)activity, sedentary behavior, stress, poor sleep, unhealthy diet, and smoking are associated with chronic pain severity and sustainment. This applies to all age categories, that is, chronic pain across the lifespan. Yet current treatment options often do not or only partly address the many lifestyle factors associated with chronic pain or attempt to address them in a standard format rather than providing an individually tailored multimodal lifestyle intervention. The evidence regarding lifestyle factors is available in adults, but limited in children and older adults having chronic pain, providing important avenues for future research. In conclusion, it is proposed that treatment approaches for people with chronic pain should address all relevant lifestyle factors concomitantly in an individually‐tailored multimodal intervention. Ultimately, this should lead to improved outcomes and decrease the psychological and socioeconomic burden of chronic pain. Level of Evidence: IV.

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Section: Resultsmentioning

confidence: 99%

Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth?

Nijs

D’Hondt

Clarys

et al. 2019

PM&R

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“…CRPS is a common disorder not completely understood, with no data available regarding the incidence of paediatric CRPS [5] because the diagnosis is uncertain and underestimated. Clinical evaluation, including a neurologic exam, combined with a thorough history collection is mandatory [4] to rule out other possible reasons for chronic pain, such as orthopaedic, neurological and rheumatologic conditions [5]. Early diagnosis is as important as or more than treatment; in fact, a longer disease course and sequelae [2] are associated with late identi cation.…”

Section: Discussionmentioning

confidence: 99%

“…Articles written in other languages. 4. Diagnosis or differential diagnosis of complex regional pain syndrome type 1.…”

Section: Case Reportsmentioning

confidence: 99%

“…CRPS type 1 affects children and adolescents aged 5 to 17 years, with a peak incidence around the 13th year of age, and it is more frequently found in women (70% of cases) [3,4]. The pathogenic mechanism is still unclear, although several hypotheses have been proposed.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic pain, generally unilateral and limb localized, autonomic and motor dysfunction and trophic disorders are the main symptoms of CRPS type 1. There are two presentations of the syndrome: the "warm" one, with red, warm, swollen skin that usually occurs in the acute phase, and the ''cold'' one, with blue/purple, cold, sweaty skin, which is usually associated with the chronic phase [3][4][5][6]. The diagnosis of CRPS type 1 is clinical and based on the Budapest diagnostic criteria [4].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Complex Regional Pain Syndrome in Children and Adolescents: A Systematic Review

Vescio

Testa

Culmone

et al. 2020

Preprint

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Background: Complex Regional Pain Syndrome (CRPS), as known as Reflex Sympathetic Dystrophy, is characterized by chronic, spontaneous and provoked pain of the distal extremities, whose severity is disproportionate to the triggering event. In growing age, CRPS affects most commonly women aged 5 to 17 years, with a maximum incidence peak around the 13th year of age. Among the orthopedics, diagnosis remains challenging, as well as, the treatment is still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age. Methods: Three reviewers searched Pubmed and Web of Science databases from their date of inception to the 20th September 2019 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines.Data extraction was performed independently by 3 reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the the Newcastle-Ottawa Quality Assessment Scale Cohort Studies. Results:A total of n = 264 articles were found. At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), cognitive-behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT+CBT is the most efficacy and suggested, but a commonly accepted protocol has been not developed. Despite the good patients outcome, several are the adverse events recorded in PT. Conclusions: Physical therapy in association with occupational, and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested.

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