Abstract

In recent years, the use of complementary and alternative medicine (CAM) in pediatric populations has increased considerably, especially for chronic conditions such as cancer, rheumatoid arthritis and cystic fibrosis in which pain may be a significant problem. Despite the growing popularity of CAM approaches for pediatric pain, questions regarding the efficacy of these interventions remain. This review critically evaluates the existing empirical evidence for the efficacy of CAM interventions for pain symptoms in children. CAM modalities that possess a published literature, including controlled trials and/or multiple baseline studies, that focused on either chronic or acute, procedural pain were included in this review. The efficacy of the CAM interventions was evaluated according to the framework developed by the American Psychological Association (APA) Division 12 Task Force on Promotion and Dissemination of Psychological Procedures. According to these criteria, only one CAM approach reviewed herein (self-hypnosis/guided imagery/relaxation for recurrent pediatric headache) qualified as an empirically supported therapy (EST), although many may be considered possibly efficacious or promising treatments for pediatric pain. Several methodological limitations of the existing literature on CAM interventions for pain problems in children are highlighted and future avenues for research are outlined.

Highlights

  • Use of complementary and alternative medicine (CAM) for Pediatric Pain: What’s the Evidence?Complementary and alternative medicine (CAM) has been defined as those interventions not generally provided by US hospitals and clinics, nor widely taught in medical schools [1]

  • This review aims to evaluate the empirical evidence for the efficacy of CAM approaches for pediatric pain problems according to the guidelines proposed by the American Psychological Association (APA) Task Force

  • Fowler-Kerry and Lander [37] compared the following four conditions on injection pain in 200 children: (i) music distraction; (ii) suggestion; (iii) distraction plus suggestion; and (iv) two control groups

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Summary

Chronic Pain

One such study by Zeltzer et al [18] examined the feasibility and acceptability of a combined acupuncture and hypnotherapy package in 33 children, 6–18 years of age (mean ϭ 13.0), referred to a tertiary chronic pain clinic. Both parents and children reported significant improvements in children’s pain and functioning following treatment. These findings support the acceptability of a combined acupuncture/hypnotherapy intervention. Because the acupuncture was part of a combined treatment package, the acceptability of acupuncture alone (i.e. without hypnotherapy) could not be determined. This study did not include a control group and, conclusions regarding the efficacy of the combined acupuncture/ hypnotherapy package could not be drawn

Pediatric Migraine
Tension Headache
Other Pain Problems
Creative Arts
Procedural Pain
Ear Pain
Functional Abdominal Pain
Pediatric oncology
Recurrent pediatric headache
Conclusions and Future Directions
Findings
Possibly efficacious Efficaciousb Promising Promising
Full Text
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