Management of Chronic Primary Pain Syndromes in Children and Adolescents

Abstract

Chronic pain is quite common in children but has become increasingly prevalent, especially among adolescent girls, over the last three decades (1-3). About 5% of schoolchildren experience high-impact chronic pain (4), which profoundly disrupts their physical, emotional, and social functioning (5-7). Despite its impact, chronic pain in children and adolescents remains largely underrecognized and undertreated, even in pediatric hospital settings (8). Without specialized management and interdisciplinary rehabilitation, the prognosis for these children can be quite poor. Additionally, there is a notable shortage of pediatric interdisciplinary chronic pain management programs, which further complicates the situation. For the first time, ICD-11 classifies different chronic pain conditions, including chronic primary pain conditions. This is an important step towards recognition and specialized treatment and rehabilitation. This lecture will focus on key disabling chronic primary pain syndromes in children and adolescents, including juvenile fibromyalgia and complex regional pain syndrome. We will explore essential aspects of managing these conditions, including diagnostics, patient education, and the roles of pharmacotherapy, exercise and physiotherapy, occupational therapy, psychological interventions, and peer support. Each of these components plays a vital role in the effective management of chronic primary pain conditions, aiming to improve the quality of life. There is a great need for physicians specializing in Physical and Rehabilitation Medicine to become actively involved in this growing field of rehabilitation.