Disease That Causes Chronic Pain in Children

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Chronic Pain in Children

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CHRONIC PAIN IN CHILDREN

Dr Sunita Goel
Lecturer in Anaesthesiology
BJ Wadia Childrens hospital

There are no published satisfactory and comprehensive community surveys of the prevalence and impact of chronic pain syndromes in children and adolescents. Assisting and guiding a child with a chronic pain disorder and the parents is an exceptional challenge.

The components of a comprehensive diagnosis of a chronic pain syndrome are:

The underlying pathology, its cause, nature and extent and whether there is associated pain, tenderness consistent with primary allodynia/ hyperalgesia.
The presence of a peripheral neuropathic disorder contributing to or causing pain.
The clinical signs of cutaneous or/and deep tissue allodynia at sites where there is no apparent pathology that is secondary allodynia with potential implications about central sensitization of nociception.
Interference with function
Associated psychological factors

Representative pediatric disorders characterized by chronic pain:

Disease	Prominent pain mechanisms	Anatomical origin	Etiology
Juvenile idiopathic arthritis	Nociceptive	Joints, tendon sheaths, entheses, often multiple	Genetic, immune, unknown
Knee (Patello- Femoral) Pain	Nociceptive	Patella and related structures including chondromalacia	Trauma, overuse
Fibromyalgia syndrome	Nociceptive, neuropathic psychogenic, unknown	Spinal structures including nerve roots	Trauma, developmental (e.g Scheurmann's), inflammatory (discitis)
Limb Pain Syndromes (growing pain)	Unknown	Limbs (especially legs)	Unknown
Complex regional pain syndromes type 1 (RSD)	Initially nociceptive, secondary neuropathic including sympathetic psychogenic	Limbs (multiple structures)	Trauma, unknown
Chronic daily headaches	Mixed (uncertain)	Head (upper cervical spine)	Trauma, psychosomatic
Brachial Plexus Injury	Peripheral neuropathy	Upper limb	Trauma
Somatization disorder	Psychogenic, uncertain	Often widespread	Anxiety, Stress

Next : Chronic Pain in Children(Contd.)

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