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Biopsychosocial Approaches to Pediatric Chronic Pain Management

  • Bonnie S. EssnerEmail author
  • Susan T. Tran
  • Marissa L. Koven
Chapter
  • 49 Downloads

Abstract

Pediatric chronic pain is prevalent among children and adolescents and the incidence is rising, resulting in considerable patient and family distress and impairment, as well as significant financial burden to health-care systems. The biopsychosocial framework has emerged as the predominant conceptualization of pediatric chronic pain. This framework highlights the complex relations among biological, psychological, sociocultural, and health behavior factors that contribute to interpersonal variability in the course and severity of chronic pain. It also guides treatment: the interdisciplinary pediatric chronic pain assessment and treatment model is structured to include clinicians of varying expertise who may together comprehensively address the biopsychosocial contributors to a given patient’s and family’s pain experience. This chapter provides an overview of the biopsychosocial framework, the interdisciplinary pediatric chronic pain treatment model, and examples of specific, evidence-based interventions including pharmacological, exercise-, and sensory discrimination-based, biobehavioral, and psychological treatments.

Keywords

Pediatric chronic pain Interdisciplinary pain treatment Biopsychosocial model Cognitive-behavioral therapy Biobehavioral treatments Physical therapy Medication and interventional procedures 

References

  1. 1.
    Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, van der Wouden JC. Pain in children and adolescents: a common experience. Pain. 2000;87:51–8.CrossRefGoogle Scholar
  2. 2.
    Huguet A, Miro J. The severity of chronic pediatric pain: an epidemiological study. J Pain. 2008;9:226–36.CrossRefGoogle Scholar
  3. 3.
    King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, MacDonald AJ. The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain. 2011;152(12):2729–38.CrossRefGoogle Scholar
  4. 4.
    Palermo TM. Cognitive-behavioral therapy for chronic pain in children and adolescents. New York: Oxford University Press; 2012.Google Scholar
  5. 5.
    Perquin CW, Hunfeld JA, Hazebroek-Kampschreur AA, van Suijlekom-Smit LW, Passchier J, Koes BW, van der Wouden JC. The natural course of chronic benign pain in childhood and adolescence: a two-year population-based follow-up study. Eur J Pain. 2003;7(6):551–9.CrossRefGoogle Scholar
  6. 6.
    Sherman AL, Bruehl S, Smith CA, Walker LS. Individual and additive effects of mothers’ and fathers’ chronic pain on health outcomes in young adults with a childhood history of functional abdominal pain. J Pediatr Psychol. 2013;38(4):365–75.CrossRefGoogle Scholar
  7. 7.
    Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C. The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine. 2006;31(4):468–72.CrossRefGoogle Scholar
  8. 8.
    Evans S, de Souza L. Dealing with chronic pain: giving voice to the experiences of mothers with chronic pain and their children. Qual Health Res. 2008;18(4):489–500.CrossRefGoogle Scholar
  9. 9.
    Palermo T, Eccleston C, Goldschneider K, et al. Assessment and management of children with chronic pain: a position statement from the American Pain Society. http://americanpainsociety.org/uploads/get-involved/pediatric-chronic-pain-statement.pdf. Accessed 17 Dec 2014.
  10. 10.
    Gatchel RJ, McGeary DD, McGeary CA, Lippe B. Interdisciplinary chronic pain management: past, present and future. Am Psychol. 2014;69(2):119–30.  https://doi.org/10.1037/a0035514.CrossRefPubMedGoogle Scholar
  11. 11.
    Schwartz GE. Testing the biopsychosocial model: the ultimate challenge facing behavioral medicine? J Consult Clin Psychol. 1982;50(6):1040–53.CrossRefGoogle Scholar
  12. 12.
    Miro J, McGrath PJ, Finley GA, Walco GA. Pediatric chronic pain programs: current and ideal practice. PAIN Reports. 2017;2(5):e613.  https://doi.org/10.1097/PR9.0000000000000613.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    American Pain Society, Special Interest Group on Pain in Infants, Children and Adolescents, Pediatric Pain Programs in North America. http://americanpainsociety.org/get-involved/shared-interest-groups/pediatric-adolescent-pain.
  14. 14.
    International Association for the Study of Pain, Guidelines for Pain Treatment Services. https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1381.
  15. 15.
  16. 16.
    Liossi C, Howard RF. Pediatric chronic pain: biopsychosocial assessment and formulation. Pediatrics. 2016;138(5):e20160331.CrossRefGoogle Scholar
  17. 17.
    Moseley LG, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004;20(5):324–30.CrossRefGoogle Scholar
  18. 18.
    Eccleston C, Fisher E, Cooper TE, Grégoire MC, Heathcote LC, Krane E, Lord SM, et al. Pharmacological interventions for chronic pain in children. Pain. 2019;160(8):1698–707.  https://doi.org/10.1097/j.pain.0000000000001609.CrossRefPubMedGoogle Scholar
  19. 19.
    Tran ST, Guite JW, Pantaleao MA, Pfeiffer M, Myer GD, et al. Preliminary outcomes of a cross-site cognitive-behavioral and neuromuscular integrative training intervention for juvenile fibromyalgia. Arthritis Care Res. 2017;69(3):413–20.  https://doi.org/10.1002/acr.22946.CrossRefGoogle Scholar
  20. 20.
    In-Albon T, Schneider S. Psychotherapy of childhood anxiety disorders: a meta-analysis. Psychother Psychosom. 2006;76(1):15–24.CrossRefGoogle Scholar
  21. 21.
    Klein JB, Jacobs RH, Reinecke MA. Cognitive-behavioral therapy for adolescent depression: a meta-analytic investigation of changes in effect-size estimates. J Am Acad Child Adolesc Psychiatry. 2007;46(11):1403–13.CrossRefGoogle Scholar
  22. 22.
    Eccleston C, Palermo TM, Williams AC, et al. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2014;2014(5):CD003968.PubMedCentralGoogle Scholar
  23. 23.
    Kashikar-Zuck S. Treatment of children with unexplained chronic pain. Lancet. 2006;367(9508):380–2.CrossRefGoogle Scholar
  24. 24.
    Wicksell RK, Olsson GL, Hayes SC. Mediators of change in acceptance and commitment therapy for pediatric chronic pain. Pain. 2011;152:2792–801.CrossRefGoogle Scholar
  25. 25.
    Wilson AC, Fales JL. Parenting in the context of chronic pain: a controlled study of parents with chronic pain. Clin J Pain. 2015;8:689.CrossRefGoogle Scholar
  26. 26.
    Olness K, Kohen D. Hypnosis and hypnotherapy with children. 3rd ed. New York: Guilford Press; 1996.Google Scholar
  27. 27.
    Dahl J, Wilson KG, Nilsson A. Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: a preliminary randomized trial. Behav Ther. 2004;35(4):785–801.CrossRefGoogle Scholar
  28. 28.
    Kashikar-Zuck S, Lynch AM, Slater S, Graham TB, Swain NF, Noll RB. Family factors, emotional functioning, and functional impairment in juvenile fibromyalgia syndrome. Arthritis Care Res. 2008;59(10):1392–8.CrossRefGoogle Scholar
  29. 29.
    Lewandowski AS, Palermo TM, Stinson J, Handley S, Chambers CT. Systematic review of family functioning in families of children and adolescents with chronic pain. J Pain. 2010;11(11):1027–38.CrossRefGoogle Scholar
  30. 30.
    Evans S, Meldrum M, Tsao JC, Fraynt R, Zeltzer LK. Associations between parent and child pain and functioning in a pediatric chronic pain sample: a mixed methods approach. Int J Disabil Hum Dev. 2010;9(1):11–21.CrossRefGoogle Scholar
  31. 31.
    Coakley R. Reflective listening from the comfort ability. 2018, February 12. Message posted to https://www.thecomfortability.com/blogs/how-to-videos/reflective-listening.
  32. 32.
    Forgeron PA, King S, Stinson JN, McGrath PJ, MacDonald AJ, Chambers CT. Social functioning and peer relationships in children and adolescents with chronic pain: a systematic review. Pain Res Manag. 2010;15(1):27–41.CrossRefGoogle Scholar
  33. 33.
    Coakley R, Wihak T, Kossowsky J, Iversen C, Donado C. The comfort ability pain management workshop: a preliminary, nonrandomized investigation of a brief, cognitive, biobehavioral, and parent training intervention for pediatric chronic pain. J Pediatr Psychol. 2017;43(3):252–65.CrossRefGoogle Scholar
  34. 34.
    Kaminsky L, Robertson M, Dewey D. Psychological correlates of depression in children with recurrent abdominal pain. J Pediatr Psychol. 2006;31(9):956–66.CrossRefGoogle Scholar
  35. 35.
    Sato AF, Hainsworth KR, Khan KA, Ladwig RJ, Weisman SJ, Davies WH. School absenteeism in pediatric chronic pain: identifying lessons learned from the general school absenteeism literature. Children’s Healthcare. 2007;36(4):355–72.CrossRefGoogle Scholar
  36. 36.
    Logan DE, Simons LE, Stein MJ, Chastain L. School impairment in adolescents with chronic pain. J Pain. 2008;9(5):407–16.CrossRefGoogle Scholar
  37. 37.
    Vervoort T, Logan DE, Goubert L, De Clercq B, Hublet A. Severity of pediatric pain in relation to school-related functioning and teacher support: an epidemiological study among school-aged children and adolescents. Pain. 2014;155(6):1118–27.CrossRefGoogle Scholar
  38. 38.
    Logan DE, Simons LE. Development of a group intervention to improve school functioning in adolescents with chronic pain and depressive symptoms: a study of feasibility and preliminary efficacy. J Pediatr Psychol. 2010;35(8):823–36.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Bonnie S. Essner
    • 1
    • 2
    Email author
  • Susan T. Tran
    • 3
  • Marissa L. Koven
    • 3
  1. 1.Pritzker Department of Psychiatry & Behavioral HealthAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  2. 2.Department of Pediatric AnesthesiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  3. 3.Department of PsychologyDePaul UniversityChicagoUSA

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