Little Stars - Treating Chronic Pain in Children

We meet Dr Stefan Friedrichsdorf, Children's Pain Expert at the Children's Hospital's and Clinics of Minneapolis in Minnesota USA. He tells us "Taking pain away is not really rocket science. It is not that difficult. We can teach any residents, any junior doctors, in one or two hours, to manage 90% of all children with acute pain, so it's not all that difficult, however most children's hospitals have not yet implemented even the standard methods of taking acute pain.

Chronic pain in children is a huge problem. More than 8 million children and teenagers in the United States suffer from chronic pain bad enough, that they miss school.

Chronic pain means that, following a thorough work up, pain remains beyond the expected time of healing. Meaning, many children may have had a minor, or even a big surgery, or an injury. They may have had an infection, and we would expect that they heal and the pain goes away, and in some of our children and teenagers, the pain just remains for days, weeks, months and years, until we see them in our clinic.

It's very important for a chronic pain patient to come into us, to actually be able to tell the whole story, and rather that by doing this over, and over, and over again, we actually have all specialists in the same room, at the same time."

We see Dr Freidrichsdorf's consultation in progress as he introduces a patient to the pain clinic and how it works. "This is the pain clinic. Are you ready? Brooke, as I talked to you about, actually lots of people in the room. The main reason that we have five people in the room, is obviously that it's pretty boring to tell your story over and over again. Since we don't want you to go from one person to the next person, to the next person, answering the same boring questions over and over again, what's going to happen is, only today, when we meet the first time, that we're actually going to go over all the questions together."

We are then introduced to the various members of the team: a social worker and family therapist, a physical therapist, a nurse, and a psychologist, and Dr Friedrichsdorf the pain specialist.

Dr Friedrichsdorf explains to Brooke "Active listening, in an inter-discipline team tells us things which are going on we may otherwise miss. The large majority of kids who come to us, they do not feel believed. They feel that doctors or hospitals don't believe them the pain is real, because when they do all these tests, when they do the ultrasound, when they do the MRI of the brain, if they do an X-ray, they don't actually find anything wrong on those pictures.

Okay, so number one, before I tell the good news, I think your pain is real. I don't think that you're crazy. I don't think that you're faking it. I don't think that you're making up this is real pain.

However, I need you to do four things at the same time, and the hard thing is, if you do the four things at the same time, sometimes pain gets worse before it gets better.

The number one thing as physical therapy is exercise. Often what happens, if I'm in pain, is that I actually become less active, and then when I become less active, I'm in more pain, so I become less active. It's often a vicious cycle. Those kids become, often, very deconditioned and do not do very well. "

Featuring
Dr Stefan Friedrichsdorf
Brooke
Andrew Warmnth
Cynthia Daughtry
Dr Kavita Desai
Janice Haines RN