Pediatric Chronic Pain

Abstract

Pediatric chronic pain has extensive and frequently sustained detrimental effects on the health, development and quality of life of young people, with an attendant adverse impact on all those invested in their well-being. It has long been appreciated that the optimal management of pediatric chronic pain addresses its equally important biological, psychological, and social components. Nevertheless, despite significant advances in its management, pediatric chronic pain remains underdiagnosed, undertreated, and misunderstood. This discrepancy is largely due to the complexity and diversity of pediatric chronic pain and resulting clinical disconnect between its biomedical and psychosocial elements. This discussion will first present two theoretical models whose tenets and constructs form the basis and justification for a biopsychosocial approach to the management of pediatric chronic pain. The utility and perhaps the necessity of incorporating pediatric health-related quality as a multidimensional clinical measure will in turn be examined. Published biopsychosocial data on the types of pediatric patients who are typically referred to a pediatric pain medicine clinic will then be reviewed. Qualitative survey data on the pediatric chronic pain experience and its attendant personal narrative will also be reviewed in further support of its biopsychosocial nature. Finally, against the backdrop of the overall goal of multidisciplinary pediatric pain management, a brief synopsis of currently available evidence-based best practices, including biomedical and psychosocial modalities, will be provided. Potential areas for future research will lastly be highlighted.