Helping children push past the pain

http://www.bostonglobe.com/lifestyle/health-wellness/2014/12/29/pediatric-pain-clinics-offer-last-resort-for-kids-with-elusive-chronic-pain/JqFoiJ387JCW8tSr4j4LbM/story.html

Over the past several years, more than 30 teaching hospitals nationwide have opened pediatric pain clinics that offer a variety of services to help children manage pain, including biofeedback training, acupuncture sessions, exercise facilities, and sleep specialists. The six-year-old Mayo Family Pediatric Pain Rehabilitation Center in Waltham, however, is one of only four programs in the country that offers an extensive outpatient program with therapists who focus on treating elusive pain conditions such as chronic migraines, fibromyalgia, or other pain syndromes that result after a virus or injury.

Chronic pain without any explainable medical cause has been a growing and more widely recognized problem in children: One in five children ages 7 to 18 report that they have weekly headaches and at least 8 percent deal with regular abdominal pain. Fourteen percent say they deal with back pain, and 4 percent with musculoskeletal pain, according to a recent study published in the medical journal Pain.

Other research published last year in the journal Pediatrics found the number of children admitted to US children’s hospitals each year for chronic pain complaints rose from 143 in 2004 to 1,188 in 2010 — an increase of 831 percent. “Kids may be having more pain than in previous generations, but physicians are also more attentive to it and doing more about it,” said Dr. Navil Sethna, clinical director of the rehabilitation center in Waltham…

The cost is steep: $2,700 per day, but insurance plans routinely cover the cost. Federal plans provided to the US military or federal employees do not…

Most pediatric pain rehabilitation centers help wean children off habit-forming drugs used to treat pain such as narcotics, muscle relaxants, and benzodiazepines…

Drug rehabs are now called Pain Rehabilitation Programs

http://nationalpaincare.com/best-pain-management-clinics/

Mayo Clinic’s Pain Rehabilitation Center in Rochester, MN focuses on weaning patients off of prescription pain medication, while providing emotional support for the anxiety and depression that chronic pain often causes… The Mayo Clinic’s high success rate speaks for itself, over 85 percent of patients in the three-week program complete rehabilitation. Over 70 percent of the patients who completed rehabilitation did not experience decreased intensity of chronic pain. The Mayo Clinic sees about 600 patients a year.

Unlike the Mayo Clinic’s Pain Rehabilitation Center, The Blaustein Pain Treatment Center focuses on treating patients through the best medical intervention possible, and they are not as focused on avoiding medication and surgery. However, a large percentage of their patients have also have an increase in quality of life, and comfort…

http://fpa-support.org/wp-content/uploads/2011/01/TucsonNewslettersNOV09.pdf

Dr. Swanson, a headache specialist at Mayo, recommended I attend Mayoʼs Pain Rehabilitation Center (PRC). I went to the three week program in June. The outpatient program spends eight hours a day teaching people with chronic pain how to better manage their lives. They took me off six medications related to my pain, including codeine and Trileptal, because they believe that chronic use of these medications do not work.

They taught me better relaxation techniques, how to better moderate my activity to prevent crashing and burning, stress management techniques, sleep hygiene, cognitive behavioral techniques that helped me to rethink my mental and behavioral responses to pain, and techniques for better managing the emotional consequences of chronic pain, like dealing with grief and anger. I worked with physical and occupational therapists to get my activity levels up but not waste energy. After graduating from the program, Iʼm doing really well. For me, getting off the drugs and working the program has reduced my everyday pain. I have had several bad days, but they are no worse than they were when I had the medication, and I am managing them a lot better. I can get out of the house, my work has improved greatly, and I have a much better outlook on life. I have the support of all of the people who were in the program with me, as well as all of the professionals at the PRC. The program saved my life. 

If you would like to learn more about Mayoʼs Pain Rehabilitation Center, go to http://www.mayoclinic.org/ pain-rehabilitationcenter-rst/ or call 507-284-2511.

http://www.painmed.org/files/hayes-press-release.pdf

Mayo Clinic Study Finds Chronic Pain Patients at High-Risk for Comorbid Substance
Abuse Benefit from Substance Use Education (2/24/2012)

“As the opioid epidemic has worsened, we clearly recognized the need for specialized content for those individuals with comorbid substance use disorders, not just opioids, but alcohol, marijuana, and other drugs,” members of the research team concluded…

http://spectrum.library.concordia.ca/978871/1/Roumanis_MSc_F2014.pdf

The Relationship between Movement and Pain Related Fear, Function, and Depression in Chronic Pain Patients (July 2014)

It is unclear which aspect of rehabilitation is responsible for improving function. In these programs, patients’ allocation to groups and post program assessments are based on subjective and self-report evaluations from the patients…

The Mayo Clinic Pain Rehabilitation Center located in Rochester, Minnesota uses an interdisciplinary rehabilitation program. The center is a tertiary hospital-based outpatient program and has existed since 1974. The program admits new patients yearly and treats 25 patients daily. Patients go through a treatment consisting of a three week intensive (120 hours) program from 8AM-5PM. First, patients go through a two day admission process which entails an evaluation of the patients’ physical and emotional stability, treatment goals, medication, and an agreement not to pursuit further medical or surgical interventions…

Another barrier of intensive interdisciplinary rehabilitation programs, is the high cost and limited insurance coverage…

However, more recently the relationship between pain intensity and physical activity is described as modestly associated…