Review of Chronic pain and the family.

This case represents an all too frequent, and tragic, example of the devastating effects of chronic pain following an injury. The problem impacts all aspects of the individual’s life, including the family. Repeated failure of various medical/surgical treatments, intending to be corrective, can result in despair, hopelessness, and anger. Even the most stoic are prone to depression. It is important to recognize and address these issues early. There are some simple strategies that can guide assessment and treatment. It can take years for such a person to “reinvent” themselves. The aware clinician can be a great source of solace and hope.

Download Full-text

Chronic pain syndromes in childhood: one trunk, many branches

Oxford Textbook of Paediatric Pain ◽

10.1093/med/9780199642656.003.0023 ◽

2013 ◽

pp. 228-236

Author(s):

Neil L. Schechter

Keyword(s):

Chronic Pain ◽

Orthostatic Intolerance ◽

Treatment Modalities ◽

Specific Information ◽

Pain Syndromes ◽

Functional Pain ◽

The Family ◽

The Common ◽

Chronic Pain Syndromes ◽

Family Distress

Although this volume is replete with detailed discussions about specific pain problems, the focus of this chapter is on a discussion of the commonalities in aetiology, associated symptoms, and treatment of many of the frequent chronic pain problems. We will explore in brief the data that demonstrates the co-occurrence of many of the common chronic pain problems in children and the epidemiological similarities that exist between affected individuals. Then we will review the concept of central sensitization and the physiological evidence that supports its presence in many of the functional pain problems. We will briefly review some of the symptoms associated with these entities (orthostatic intolerance, sleep disturbance, depression, anxiety, hypermobility, family distress). Finally, we will discuss briefly a general approach to these problems emphasizing the collection of specific information in the history and physical examination, the critically important presentation of the formulation to the family, and the treatment modalities that appear to be effective for many of these conditions. In-depth discussion of each of these pain problems is available in chapters specifically designated to review them in detail.

Download Full-text