The multidisciplinary approach to pain treatment
Symptoms of chronic or recurrent pain in children and adolescents are common. Research studies show that as many as 30 percent to 40 percent of children and teens complain of pain that occurs at least once per week (Palermo, 2000).
Who should treat my (or my child’s) pain problem?
The “state of the art” treatment for pediatric chronic pain at Boston Children's Hospital is the Multidisciplinary Pain Management team approach, with a team that usually consists of:
Pediatric Pain Management Specialist
Typically, these physicians are pediatricians and/or anesthesiologists with extra training in treating children with pain problems. The physician evaluates the child’s pain and makes decisions regarding the best treatment options. He or she will work with the family to determine what combinations of medication treatments, physical therapy, psychological services and possibly other medical interventions will work best for each patient.
Psychologists who are experts in pain management can help children and families develop skills for coping with pain. There are a variety of “cognitive behavioral” approaches, such as relaxation techniques, that are effective in decreasing pain. Psychologists often also work with children and families to help them increase the child’s level of functioning (i.e. going to school, interacting with peers, doing the things he or she used to do before the pain developed). They can also address feelings of anxiety, sadness, anger and frustration that often develop in children and adolescents who face chronic pain problems.
Nurse or Nurse Practitioner
Often a nurse or nurse practitioner works as a member of the team, providing education to the family about pain disorders and pain management—and helping the family with questions or concerns that arise during treatment.
Physical therapy (PT) is often a highly effective form of treatment for chronic pain disorders. PT’s work with the patient and family to determine the best physical activities, exercises and other treatments for the patient, in order to increase the patient’s strength and endurance and help him or her deal with day-to-day activity requirements.
Pain affects the quality of both the patient's and the family's daily life. Learning techniques to actively manage the pain helps the effectiveness of pain treatment. So we often refer patients and their families to a clinical psychologist who specializes in the treatment of chronic pain.
Follow-up appointments may be scheduled at Boston Children's Hospital, or at a community location that's convenient for the patient and family. Biobehavioral techniques such as relaxation training, biofeedback and cognitive pain control are taught. We also recommend supportive family counseling, and encourage patients and their families to take an active role in their own care.