Abstract
Chronic and recurrent pain is defined as pain that persists or recurs for longer than 3 months. Chronic pain is common in childhood, impacting at least one in four youth. The etiology of chronic pain is best understood within a biopsychosocial framework, which emphasizes the intersection of biological processes, psychological factors, and social/environmental influences in both the onset and maintenance of chronic pain. Children and adolescents with chronic pain can experience disability of physical function, psychological distress, family conflict, and difficulties in school and social functioning. Given the degree of potential physical and psychosocial consequences, assessment and treatment of pediatric chronic pain typically involves an interprofessional team including physicians, psychologists, and physical/occupational therapists who specialize in pediatric pain medicine. In this chapter, we use a biopsychosocial framework to describe the evaluation and treatment of chronic pain in childhood. Implications for interprofessional care and future directions are also discussed.
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References
Asmundson, G. J., Noel, M., Petter, M., & Parkerson, H. A. (2012). Pediatric fear-avoidance model of chronic pain: Foundation, application and future directions. Pain Research and Management, 17(6), 397–405.
Assa, A., Ish-Tov, A., Rinawi, F., & Shamir, R. (2015). School attendance in children with functional abdominal pain and inflammatory bowel diseases. Journal of Pediatric Gastroenterology and Nutrition, 61(5), 553–557.
Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43(3), 309–322.
Chow, E. T., Otis, J. D., & Simons, L. E. (2016). The longitudinal impact of parent distress and behavior on functional outcomes among youth with chronic pain. Journal of Pain, 17(6), 729–738.
Cohen, L. L., Lemanek, K., Blount, R. L., Dahlquist, L. M., Lim, C. S., Palermo, T. M., … Weiss, K. E. (2008). Evidence-based assessment of pediatric pain. Journal of Pediatric Psychology, 33(9), 939–955.
Cooper, T. E., Fisher, E., Anderson, B., Wilkinson, N. M., Williams, D. G., & Eccleston, C. (2017). Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews, 8, CD012539.
Cooper, T. E., Fisher, E., Gray, A. L., Krane, E., Sethna, N., van Tilburg, M. A., … Wiffen, P. J. (2017). Opioids for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews, 7, CD012538.
Cooper, T. E., Heathcote, L. C., Clinch, J., Gold, J. I., Howard, R., Lord, S. M., … Wiffen, P. J. (2017). Antidepressants for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews, 8, CD012535.
Costa-Silva, M. A., Prado, A. C. d. A., Souza, L. C. d., Gomez, R. S., & Teixeira, A. L. (2016). Cognitive functioning in adolescents with migraine. Dementia & Neuropsychologia, 10, 47–51.
Cunningham, N. R., Cohen, M. B., Farrell, M. K., Mezoff, A. G., Lynch-Jordan, A., & Kashikar-Zuck, S. (2015). Concordant parent-child reports of anxiety predict impairment in youth with functional abdominal pain. Journal of Pediatric Gastroenterology and Nutrition, 60(3), 312–317.
Cunningham, N. R., Jagpal, A., Tran, S. T., Kashikar-Zuck, S., Goldschneider, K. R., Coghill, R. C., & Lynch-Jordan, A. M. (2016). Anxiety adversely impacts response to cognitive behavioral therapy in children with chronic pain. Journal of Pediatrics, 171, 227–233.
Cunningham, N. R., Nelson, S., Jagpal, A., Moorman, E., Farrell, M., Pentiuk, S., & Kashikar-Zuck, S. (2018). Development of the Aim to Decrease Anxiety and Pain Treatment (ADAPT) for pediatric functional abdominal pain disorders. Journal of Pediatric Gastroenterology and Nutrition, 66(1), 16–20.
Dalla Libera, D., Colombo, B., Pavan, G., & Comi, G. (2014). Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: The tip of the iceberg. Neurological Sciences, 35(Suppl 1), 145–148.
Dick, B. D., & Pillai Riddell, R. (2010). Cognitive and school functioning in children and adolescents with chronic pain: A critical review. Pain Research and Management, 15(4), 238–244.
Eccleston, C., Cooper, T. E., Fisher, E., Anderson, B., & Wilkinson, N. M. (2017). Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews, 8, CD012537.
Eccleston, C., Jordan, A., McCracken, L. M., Sleed, M., Connell, H., & Clinch, J. (2005). The Bath Adolescent Pain Questionnaire (BAPQ): Development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents. Pain, 118(1–2), 263–270.
Eccleston, C., Palermo, T. M., Williams, A. C., Lewandowski Holley, A., Morley, S., Fisher, E., & Law, E. (2014). Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database of Systematic Reviews, 5, CD003968.
Evans, S., Lung, K. C., Seidman, L. C., Sternlieb, B., Zeltzer, L. K., & Tsao, J. C. (2014). Iyengar yoga for adolescents and young adults with irritable bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition, 59(2), 244–253.
Fales, J., Palermo, T. M., Law, E. F., & Wilson, A. C. (2015). Sleep outcomes in youth with chronic pain participating in a randomized controlled trial of online cognitive-behavioral therapy for pain management. Behavioral Sleep Medicine, 13(2), 107–123.
Fearon, P., & Hotopf, M. (2001). Relation between headache in childhood and physical and psychiatric symptoms in adulthood: National birth cohort study. British Medical Journal, 322(7295), 1145.
Fisher, E., Law, E., Palermo, T. M., & Eccleston, C. (2014). Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents. Cochrane Database of Systematic Reviews, 2014, CD011118.
Fitzcharles, M.-A., Rampakakis, E., Ste-Marie, P. A., Sampalis, J. S., & Shir, Y. (2014). The association of socioeconomic status and symptom severity in persons with fibromyalgia. The Journal of Rheumatology, 41(7), 1398–1404.
Forgeron, P. A., King, S., Stinson, J. N., McGrath, P. J., MacDonald, A. J., & Chambers, C. T. (2010). Social functioning and peer relationships in children and adolescents with chronic pain: A systematic review. Pain Research and Management, 15(1), 27–41.
Forgeron, P. A., MacLaren Chorney, J., Carlson, T. E., Dick, B. D., & Plante, E. (2015). To befriend or not: Naturally developing friendships amongst a clinical group of adolescents with chronic pain. Pain Management Nursing, 16(5), 721–732.
Groenewald, C. B., Wright, D. R., & Palermo, T. M. (2015). Health care expenditures associated with pediatric pain-related conditions in the United States. Pain, 156(5), 951–957.
Gulewitsch, M. D., Muller, J., Hautzinger, M., & Schlarb, A. A. (2013). Brief hypnotherapeutic-behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: A randomized controlled trial. European Journal of Pediatrics, 172(8), 1043–1051.
Hainsworth, K. R., Salamon, K. S., Khan, K. A., Mascarenhas, B., Davies, W. H., & Weisman, S. J. (2014). A pilot study of yoga for chronic headaches in youth: Promise amidst challenges. Pain Management Nursing, 15(2), 490–498.
Harris, M. A., Wagner, D. V., Wilson, A. C., Spiro, K., Heywood, M., & Hoehn, D. (2015). Novel interventions in children’s healthcare for youth hospitalized for chronic pain. Clinical Practice in Pediatric Psychology, 3(1), 48–58.
Heathcote, L. C., Vervoort, T., Eccleston, C., Fox, E., Jacobs, K., Van Ryckeghem, D. M., & Lau, J. Y. (2015). The relationship between adolescents’ pain catastrophizing and attention bias to pain faces is moderated by attention control. Pain, 156(7), 1334–1341.
Hechler, T., Kanstrup, M., Holley, A. L., Simons, L. E., Wicksell, R., Hirschfeld, G., & Zernikow, B. (2015). Systematic review on intensive interdisciplinary pain treatment of children with chronic pain. Pediatrics, 136(1), 115–127.
Higgins, K. S., Birnie, K. A., Chambers, C. T., Wilson, A. C., Caes, L., Clark, A. J., … Campbell-Yeo, M. (2015). Offspring of parents with chronic pain: A systematic review and meta-analysis of pain, health, psychological, and family outcomes. Pain, 156(11), 2256–2266.
Holley, A. L., Wilson, A. C., & Palermo, T. M. (2017). Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: A prospective study. Pain, 158(5), 794–801.
Holsti, L., Backman, C. L., & Engel, J. M. (2014). Occupational therapy. In P. J. McGrath, B. Stevens, S. M. Walker, & W. T. Zempsky (Eds.), Oxford textbook of pediatric pain. Oxford: Oxford University Press.
IASP Taxonomy Working Group. (2011). Classification of chronic pain (2nd ed.). Retrieved October 20, 2017, from http://www.iasp-pain.org/PublicationsNews/Content.aspx?Itemnumber=1673&navItemNumber=677.
Kashikar-Zuck, S., Zafar, M., Barnett, K. A., Aylward, B. S., Strotman, D., Slater, S. K., … Powers, S. W. (2013). Quality of life and emotional functioning in youth with chronic migraine and juvenile fibromyalgia. Clinical Journal of Pain, 29(12), 1066–1072.
King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain, 152(12), 2729–2738.
Law, E. F., Beals-Erickson, S. E., Fisher, E., Lang, E. A., & Palermo, T. M. (2017). Components of effective cognitive-behavioral therapy for pediatric headache: A mixed-methods approach. Clinical Practice in Pediatric Psychology, 5(4), 376–391.
Law, E. F., Fisher, E., Howard, W. J., Levy, R., Ritterband, L., & Palermo, T. M. (2017). Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain. Pain, 58(10), 1992–2000.
Levy, R. L., Langer, S. L., van Tilburg, M. A., Romano, J. M., Murphy, T. B., Walker, L. S., … Feld, A. D. (2017). Brief telephone-delivered cognitive behavioral therapy targeted to parents of children with functional abdominal pain: A randomized controlled trial. Pain, 158(4), 618–628.
Lewandowski, A. S., Palermo, T. M., Stinson, J., Handley, S., & Chambers, C. T. (2010). Systematic review of family functioning in families of children and adolescents with chronic pain. Journal of Pain, 11(11), 1027–1038.
Lewandowski, A. S., Toliver-Sokol, M., & Palermo, T. M. (2011). Evidence-based review of subjective pediatric sleep measures. Journal of Pediatric Psychology, 36(7), 780–793.
Miller, I. W., Epstein, N. B., Bishop, D. S., & Keitner, G. I. (1985). The McMaster family assessment device: Reliability and validity. Journal of Marital and Family Therapy, 11(4), 345–356.
Naar-King, S., Ellis, D., King, P. S., Lam, P., Cunningham, P., Secord, E., … Templin, T. (2014). Multisystemic therapy for high-risk African American adolescents with asthma: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 82(3), 536–545.
Noel, M., Wilson, A. C., Holley, A. L., Durkin, L., Patton, M., & Palermo, T. M. (2016). Post-traumatic stress disorder symptoms in youth with versus without chronic pain. Pain, 157(10), 2277–2284.
Palermo, T. M. (2008). Validation of a self-report questionnaire version of the Child Activity Limitations Interview (CALI): The CALI-21. Pain Research and Management, 139(3), 644–652.
Palermo, T. M. (2012). Cognitive-behavioral therapy for chronic pain in children and adolescents. New York, NY: Oxford University Press.
Palermo, T. M., Beals-Erickson, S., Bromberg, M., Law, E., & Chen, M. (2017). A single arm pilot trial of brief cognitive behavioral therapy for insomnia in adolescents with physical and psychiatric comorbidities. Journal of Clinical Sleep Medicine, 13(3), 401–410.
Palermo, T. M., & Chambers, C. T. (2005). Parent and family factors in pediatric chronic pain and disability: An integrative approach. Pain, 119(1–3), 1–4.
Palermo, T. M., Law, E. F., Bromberg, M., Fales, J., Eccleston, C., & Wilson, A. C. (2016). Problem-solving skills training for parents of children with chronic pain: A pilot randomized controlled trial. Pain, 157(6), 1213–1223.
Palermo, T. M., Law, E. F., Fales, J., Bromberg, M. H., Jessen-Fiddick, T., & Tai, G. (2016). Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: A randomized controlled multicenter trial. Pain, 157, 174–185.
Palermo, T. M., Riley, C. A., & Mitchell, B. A. (2008). Daily functioning and quality of life in children with sickle cell disease pain: Relationship with family and neighborhood socioeconomic distress. Journal of Pain, 9, 833–840.
Palermo, T. M., Valrie, C. R., & Karlson, C. W. (2014). Family and parent influences on pediatric chronic pain: A developmental perspective. American Psychologist, 69, 142–152.
Powers, S. W., Coffey, C. S., Chamberlin, L. A., Ecklund, D. J., Klingner, E. A., Yankey, J. W., … CHAMP Investigators. (2017). Trial of amitriptyline, topiramate, and placebo for pediatric migraine. New England Journal of Medicine, 376, 115–124.
Rabbitts, J. A., Fisher, E., Rosenbloom, B. N., & Palermo, T. M. (2017). Prevalence and predictors of chronic postsurgical pain in children: A systematic review and meta-analysis. Journal of Pain, 18, 605–614.
Simons, L. E., Kaczynski, K. J., Conroy, C., & Logan, D. E. (2012). Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: Associations with treatment response. Journal of Pain, 13, 1151–1161.
Simons, L. E., Sieberg, C. B., Conroy, C., Randall, E. T., Shulman, J., Borsook, D., … Logan, D. E. (2018). Children with chronic pain: Response trajectories following intensive pain rehabilitation treatment. Journal of Pain, 19(2), 207–218.
Stancin, T. (2016). Commentary: Integrated pediatric primary care: Moving from why to how. Journal of Pediatric Psychology, 41, 1161–1164.
Stinson, J. N., Kavanagh, T., Yamada, J., Gill, N., & Stevens, B. (2006). Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain, 125(1–2), 143–157.
Stone, A. L., & Wilson, A. C. (2016). Transmission of risk from parents with chronic pain to offspring: An integrative conceptual model. Pain, 157, 2628–2639.
Swain, M. S., Henschke, N., Kamper, S. J., Gobina, I., Ottova-Jordan, V., & Maher, C. G. (2014). An international survey of pain in adolescents. BMC Public Health, 14, 447.
Torkamani, M., Ernst, L., Cheung, L. S., Lambru, G., Matharu, M., & Jahanshahi, M. (2015). The neuropsychology of cluster headache: Cognition, mood, disability, and quality of life of patients with chronic and episodic cluster headache. Headache, 55, 287–300.
Tupper, S. M., Swiggum, M. S., O’Rourke, D., & Sangster, M. (2014). Physical therapy interventions for pain in childhood and adolescence. In P. McGrath, B. Stevens, S. Walker, & B. Zempsky (Eds.), Oxford textbook of paediatric pain (pp. 581–589). Oxford: Oxford University Press.
Van Slyke, D. A., & Walker, L. S. (2006). Mothers’ responses to children’s pain. Clinical Journal of Pain, 22, 387–391.
Vervoort, T., Logan, D. E., Goubert, L., De Clercq, B., & Hublet, A. (2014). Severity of pediatric pain in relation to school-related functioning and teacher support: An epidemiological study among school-aged children and adolescents. Pain, 155, 1118–1127.
Walker, L. S., Sherman, A. L., Bruehl, S., Garber, J., & Smith, C. A. (2012). Functional abdominal pain patient subtypes in childhood predict functional gastrointestinal disorders with chronic pain and psychiatric comorbidities in adolescence and adulthood. Pain, 153, 1798–1806.
Weiss, K. E., Harbeck-Weber, C., Zaccariello, M. J., Kimondo, J. N., Harrison, T. E., & Bruce, B. K. (2017). Executive Functioning in Pediatric Chronic Pain: Do Deficits Exist?. Pain Medicine, 19(1), 60–67.
Westergaard, M. L., Glümer, C., Hansen, E. H., & Jensen, R. H. (2014). Prevalence of chronic headache with and without medication overuse: Associations with socioeconomic position and physical and mental health status. Pain, 155, 2005–2013.
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Dudeney, J., Law, E.F. (2018). Chronic and Recurrent Pain. In: Forman, S., Shahidullah, J. (eds) Handbook of Pediatric Behavioral Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-030-00791-1_10
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