A unique multidisciplinary outpatient pain program for children, adolescents and young adults with chronic pain

Abstract

Chronic pain affects approximately 3% of adolescents ages 11-18 years of age. Most pain in children is also accompanied by social and psychological disruptions. Severe pain can also have an effect on development as a result of missing school, missed social activities and suffering with depression. Nationwide Children's Hospital offers a unique multidisciplinary outpatient pain program for children, adolescents and young adults with chronic pain and/or fatigue. The program includes medical management with medication, vitamins and supplements; psychology for Cognitive Behavioral Therapies, relaxation therapy, biofeedback, stress management and coping skills; physical therapy to help an individual learn to interpret pain signals, and manage and decrease symptoms through exercise; and massage therapy or acupuncture for pain management and relaxation. The patients are evaluated at an intake visit with a medical provider, psychologist and physical therapist to determine an individualized treatment plan. Patients return to the program for therapies in the full program on a bi-weekly to monthly basis. Patients and parents complete questionnaires including PedsQL, Pain Coping Questionnaire, Child Symptom Inventory, Mood and Feeling Questionnaire and Functional Disability Inventory at the initial intake and at graduation from the full program along with completion of PedsQL on a monthly basis while in the program. Over the past two years 271 patients were evaluated in the Pain Services Clinic at NCH. The patients were primarily referred by Rheumatology, GI, PCP, Hematology/Oncology, Sports Medicine and Orthopedics. Depending on the patient's medical needs and insurance coverage patients were placed in a slot in the full program with massage or acupuncture along with physical therapy, psychology and medical management. Patient's progress is evaluated by looking at functioning and monitoring the PedsQL Questionnaires. The poster will show data regarding patient characteristics, attendance rates, diagnoses and graduation outcome rate. (Hechler, E J Pain, 2010.)