Complex pain in young children

Abstract

Objective. Early childhood is a time of rapid development, particularly of the central nervous system, and can set a foundation for the entire life course. Complex pain in young children can impact the quality of life through limiting physical and social development, compromising psychological well-being, and disrupting sleep. The aim of this review is to identify the needs of young children who present to a tertiary-level pain service, what services they require, and their treatment outcomes. There are limited data on this vulnerable population, which may be due to small numbers represented and the complexities of pain assessment in this age group. Method. A retrospective chart review recorded demographics, gender, pain location and etiology, treatment, and outcomes of 28 children younger than age eight years attending a pediatric pain clinic over a three-year period. Results. All but two young children had an obvious physical pathology as an explanation for pain; this is in contrast to studies of pain clinics servicing adolescents. A diverse range of conditions, some rare, were identified, requiring a high level of pediatric understanding of the disease process and an ability to work with primary teams with expertise in disease-modifying strategies.