Chronic pain is often a frustrating problem for those struggling with it and its treatment often requires the expertise of individuals from many different disciplines. With this in mind, the Chronic Pain Clinic at Boston Children's Hospital takes a multidisciplinary approach to evaluating and treating children and young adults with persistent pain.
All children referred to the Chronic Pain Clinic are seen by multidisciplinary team of physicians, nurses, psychologists and physical therapists who are dedicated to caring for children, adolescents and young adults with chronic pain on an outpatient basis. We recommend a personalized treatment plan for each patient intended to address not just the pain itself but also any disabilities it may have caused.
Conditions evaluated by the Chronic Pain Clinic include:
complex regional pain syndrome (the new name for reflex sympathetic dystrophy)
widespread musculoskeletal pain
persistent post-surgical pain
pain associated with sports injury or other orthopedic problems
pain in multiple locations
While many children who come to the Chronic Pain Clinic complain of headache as part of their chronic pain, Boston Children's Headache Program cares for children for whom headache is the main concern.
A child's specific pain treatment plan depends on a number of factors, such as the nature and cause of the pain. We may suggest several options for pain management, including:
medications for nerve pain
cognitive behavioral approaches (e.g., biofeedback, relaxation, meditation, guided imagery, reframing)
transcutaneous electrical nerve stimulation
complementary techniques such as acupuncture, reiki and massage
Some of those services may be provided on site, but for many children we are often able to identify providers closer to home. We can also help work with schools to plan your child's return to school or help recommend modifications to your child's school environment so as to eliminate pain triggers. In addition, we can address the impacts of chronic pain on sleep, which can be challenging for all people who are in pain.
If our team will make additional referrals if your child's needs warrant further medical evaluation. In addition, if your child's pain is sufficiently disabling, the team will recommend admission to the Mayo Family Pediatric Pain Rehabilitation Center (PPRC), an intensive rehabilitation program that serves the needs of children and adolescents with chronic musculoskeletal and neuropathic pain. All patients considered for admission to the PPRC must first be screened in the Chronic Pain Clinic.
Referral to the Chronic Pain Clinic
Primary care providers and specialists can refer patients to the Chronic Pain Clinic; families can also self-refer. After an initial phone call, families receive a questionnaire by email, asking for detailed information about their child. That information will help us decide if the Chronic Pain Clinic is an appropriate setting and if so, accelerate the evaluation process.
Initial evaluation of a new patient takes half a day. Families are greeted on arrival by our clinic staff and given the schedule for the day. Our team assembles a comprehensive medical history based on the electronic questionnaire and clinical interview. Patients are given a comprehensive physical examination and a detailed physical therapy evaluation; families and children also undergone a psychological assessment during the visit.
Once all of the evaluations are complete and our staff has reviewed the results, we will develop and share treatment recommendations with the family.
Most patients seen in the Chronic Pain Clinic will require subsequent follow-up visits to evaluate their progress and to determine whether your child's treatment plan has been effective. The plan may change depending on how your child's pain has responded to therapy. Ongoing follow-up by our nursing staff is also a critical part of our care.
Education and Research
The Chronic Pain Clinic is one of the oldest and largest pediatric pain centers in the world, and a major training site for new doctors in the field of pediatric pain medicine. For this reason, fellows being trained in pain medicine may participate in your child's evaluation .One of our highly experienced attending physicians, however, will always closely supervise your care and will be present throughout the evaluation.
The Chronic Pain Clinic is dedicated to advancing the field of pediatric pain medicine and through research providing new information to help children in pain. We take this responsibility very seriously, and you may be asked to participate in some of our ongoing research. If asked and if you are comfortable with the research that is proposed, we would welcome your participation. If not, this will in no way impact the care that you will receive, which we believe to be of the highest possible quality.
To contact the Chronic Pain Clinic for more information, or to request an appointment for your child or patient, contact us at 617-355-7040.
We are located at 333 Longwood Avenue, Boston MA, across the street from Boston Children's main campus.