Current Understanding of Optimal Self-Management Strategies and Approaches for Youth With Amplified Musculoskeletal Pain Conditions

Abstract

Amplified musculoskeletal pain is a common presenting condition among youth seen by pediatric rheumatologists, with optimal outcomes often contingent in large part on the degree to which patients understand and implement appropriate self-management strategies. This review aims to provide readers with a contemporary understanding of approaches to self-management that can be recommended for improving health outcomes for pediatric amplified pain conditions. Recent research on self-management of pain and health behaviors for youth with amplified pain conditions has suggested at least short-term benefits for engaging in specific types of physical training (neuromuscular exercise training), for applying healthy sleep habits acquired through cognitive-behavioral therapy for insomnia, and for learning and applying pain coping skills such as relaxation and cognitive retraining. Emerging areas include parent-targeted and technology-assisted interventions to help optimize child pain self-management and outcomes, and intensive training in a variety of self-management skills through pain rehabilitation programs. Although self-management is recognized as integral to optimizing outcomes for youth with amplified pain and there are some recent innovations in this area, research to direct specific suggestions remains somewhat underdeveloped. The most robust efficacy evidence exists for training in cognitive-behavioral pain coping skills, but in what format and at what intensity benefits which type of patient or for how long remain important questions to be explored in future studies.