Chronic Pain Program
What is the Chronic Pain Program?
The Chronic Pain Program at The Hospital for Sick Children is a specialized clinical service for children and adolescents with chronic pain. It is a child-centered evidence-based health care program.
Many children suffer from chronic pain. This pain adversely affects all aspects of their lives - physical, social, and emotional. Some children may even become severely disabled and distressed.
Usually, chronic pain has multiple causes and contributing factors requiring a multidisciplinary pain team (medicine, nursing, physiotherapy, psychology, and psychiatry) to assess and treat children with complex pain problems. Children receive individual treatment plans to target each of the causes and contributing factors that provoke pain episodes, intensify pain intensity, or prolong disability.
What Types of Pain Problems are treated?
All types of chronic pain problems are treated, including:
- Chronic musculoskeletal pain
- Complex regional pain syndromes (e.g. reflex sympathetic dystrophy)
- Fibromyalgia
- Chronic neurological conditions
- Chronic fatigue syndromes
- Phantom limb pain
- Chronic daily headache
- Pain of unknown cause
What treatments are Provided?
The specific treatment plan depends on the assessment results - the causes and contributing factors for a particular child's pain problem. Treatment may include appropriate medication, physical therapy, non-drug pain control methods, cognitive-behavioral therapy, and counseling.
What happens when a child is referred?
The clinic coordinator will contact the parents and referring physician to obtain the needed background information. Parents will be asked to complete a short intake form and then a consultation appointment will be scheduled. At the consultation (about 90 minutes), the team reviews the medical and pain history, conducts an assessment interview with the child and parents, examines the child to detail sensory abnormalities, establishes the diagnosis, and develops a specific treatment plan.
The team provides children and their families with an understanding of the pain diagnosis and relevant factors contributing to pain and disability, a practical discussion of the available treatment options, the rationale for the therapies recommended (usually a combination of pharmacological, physical, behavioral, and psychological), and a well-defined care plan with goals and evaluation plans.
What else should I know?
Unlike acute pain, where pain is often directly related to a single disease or injury, chronic pain has multiple and complex causes. The mechanisms responsible for chronic pain are different from those responsible for acute pain. Chronic pain is associated with changes at many levels in the nervous system that can lead to altered sensitivity to touch, abnormal skin color, and temperature changes on the skin surface.
The most effective treatment for chronic pain is a multidisciplinary approach combining pharmacological, physical, behavioral, and psychological therapies to modify the multiple factors that cause pain, distress, and disability.