REVIEW   Free access

Minerva Anestesiologica 2018 September;84(9):1081-92

DOI: 10.23736/S0375-9393.18.12367-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Chronic non-cancer pain in children: we have a problem, but also solutions

Eduardo VEGA ^{1, 2}, Yves BEAULIEU ¹, Rachel GAUVIN ¹, Catherine FERLAND ^{1, 3}, Stephanie STABILE ¹, Rebecca PITT ¹, Victor H. GONZALEZ CARDENAS ^{1, 4}, Pablo M. INGELMO ^{1, 3} ✉

¹ Chronic Pain Service, Department of Anesthesia, Montreal Children’s Hospital, McGill University Health Center, Montreal, Canada; ² Department of Anesthesia, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile; ³ The Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada; ⁴ University Foundation for Health Sciences, Bogotá, Colombia

Chronic non-cancer pain in children and adolescents has been described as “a modern public health disaster” that has generated significant medical and economic burdens within society. Seen as a disease in its own right, chronic pain has short and long-term consequences that impact not only the patient’s health but also that of friends and families, due to significant parenting stress and disruptions in family life and structure. The evidence supporting pharmacological treatments and interventional procedures is limited, and no single strategy has been shown to be completely effective in children with chronic non-cancer pain. Therefore, considering the multifactorial nature of chronic pain, these patients should be treated with a multidisciplinary, balanced approach that seeks a primary outcome of improved functioning rather than of pain reduction. Using a bio-psycho-social approach, a multidisciplinary team, including a physiotherapist, nurse, social worker, psychologist, and physician, has been effective in achieving this outcome of improved functioning in children and adolescents with chronic pain. In this review, we discuss the impact, associated conditions, and evolution of chronic pain, along with the crucial role of every member of a multidisciplinary chronic pain clinic involved in the care of the children and adolescents with chronic non-cancer pain.

KEY WORDS: Chronic pain - Child - Adolescent - Pain clinics - Interdisciplinary research