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…

2 thoughts on “Helping children push past the pain

  1. It is true that the children in pain have increased significantly, but probably due to the rising number of kids born with chronic illnesses. So, the problem is that when they are enrolled in the pain clinics (of which I know a bit about) they are likely never to be weaned of the narcotics. The pain doesn’t go away. Their diseases are going to stay with them forever. Plus, things get worse for them after each surgery or procedure. Then we are back to children on narcotics.

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    • The purpose of the clinic is to teach people how to live with pain, not to make their pain go away. With kids, this is much harder to do, as they have their whole lives to look forward to, and a future of pain and more pain is daunting and hard to look at. Many adult pain patients abuse drugs and alcohol to keep from looking at their future…

      However, in my experience, teaching people to live with pain is not an easy thing to do. Not only that, but a pain patient’s needs can change almost daily. A different combination of therapy and treatments needs to be crafted for each individual — not something our healthcare system is able to do. It falls on pain patients to try and then keep or discard the available treatments and to devise their own program.

      And whether ya’ll like it or not, some people will not be able to manage their pain without drugs. And the drugs that work for pain come with risks, just like chemotherapy. One of the risks is tolerance, which patients of all ages need to understand. But this risk can be mitigated, and patients need to learn how to do so, especially kids.

      You can hope that new drugs that aren’t narcotics will help pain patients, but as someone who has taken almost every kind of drug to manage pain, I am very skeptical. Pain has been my constant companion for almost 3 decades. I know pain more than any other feeling. And my experience says that to treat constant pain, an opiate is needed. Not for everyone, and not continuously, but a good part of the time. It’s either constant pain and constant suffering, or constant pain and brief periods of relief.

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