A team including nurses, physicians and other pediatric specialists review all aspects of your child's complex pain issues. They work together to develop diagnosis and treatment plans to increase your child's comfort and function in everyday life.
Treatment of acute pain is often directed toward treating the cause of the pain, as well as using specific pain medications or nerve blocks. Supportive interventions such as parental comforting, massage, distraction, games and offering the child participation in their care are critical components in addition to pain medications. The primary aim of acute pain care is to reduce suffering while simultaneously avoiding serious side effects from pain medicines and interventions.
Treatment for chronic pain involves ensuring that no further bodily injury is present, then working toward greater function. Chronic pain is pain that persists long after the tissue injury would have normally healed and pain gone away. Causes vary and are sometimes related to ongoing medical conditions.
Pain medications used for acute pain are less helpful with chronic pain. When prescription medications are used, these medicines are often used for improving mood, reducing anxiety, and treating other side effects of the pain. There is rarely a completely effective direct medical treatment for chronic pain in the same direct way that acute pain responds to pain medicines. The primary aim of chronic pain care is to focus the patient on wellness behaviors, strive for increasing normal functioning despite persistent pain and using non-pharmacologic interventions to decrease pain, suffering and disability.
During clinic visits, families will learn pain management skills, lifestyle modifications and functional goals for the patient. Restoring the patient's everyday function is emphasized through physical and mind-based therapies.
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In January , Micole Hopke and her husband, Patrick, went for what they assumed would be a routine checkup of Try Hands-On Healing Last year, a comprehensive research review published by the Agency for Healthcare Research and Quality found good evidence that acupuncture helped with chronic back and neck pain and fibromyalgia, that massage helped with chronic back pain and fibromyalgia, and that spinal manipulation helped with chronic back pain and tension headaches.
And a review by the American College of Physicians found that heat can help ease back pain. Hands-on therapies help in two ways, Schneiderhan says. A therapist with a solid understanding of anatomy and physiology can help address a physical problem that is triggering pain.
For example, massage can break up scar tissue, improve circulation, and help relax tight muscles that may be putting pressure on nearby nerves. Hands-on treatments increase awareness of the many small factors that contribute to pain, such as slouching at a desk for hours. Harness Brain Power The gold standard for psychological treatment of chronic pain is cognitive behavioral therapy.
Through a limited, goal-oriented set of CBT sessions—typically seven to 12—the therapist can teach a patient to identify thoughts and behaviors that worsen pain, and replace them with new thought patterns designed to calm the nervous system and relieve pain. Ask your doctor for a referral or look for a therapist who has training and experience in treating chronic pain, Darnall says.
CBT for pain is generally covered by insurance, and sessions can take place in person, online, or by phone. Other psychological approaches, such as progressive relaxation exercises, mindfulness, and meditation—alone or with CBT—also have been shown to reduce pain. The goal of pills, patches, and creams is to take the pain down a couple of notches to allow for exercise, work, and socializing—activities vital to recovery.
The risks of more potent drugs, such as opioids, often outweigh the benefits. Most get far less relief.
Marijuana may relieve certain types of pain. And though little research has been done in humans, preliminary findings suggest that cannabidiol CBD , a cannabis compound found in marijuana, can reduce inflammation, which could alleviate pain. Fish oil reduces inflammation and helps some with rheumatoid arthritis pain. NSAIDs are typically better for muscle and joint pain, Tauben says; neither is very effective against nerve pain, such as that from shingles.
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NSAIDs can be powerful. A JAMA study showed that patients who received ibuprofen plus acetaminophen for severe pain reported the same amount of pain reduction as those who received an opioid plus acetaminophen.
Always check with your doctor before combining any drugs, taking more than the recommended dose, or continuing an OTC drug for longer than 10 days. Side effects for ibuprofen can include heart attack or stroke, stomach bleeding and kidney disease; for acetaminophen: liver disease. Topical Pain Relievers Pain relievers in cream or patch form—OTC or prescription—may cause fewer side effects than pills because less of the drug is absorbed into the bloodstream. Their ingredients can help in one of three ways: by reducing pain and inflammation NSAIDs or aspirinlike compounds called salicylates , by producing a feeling of heat or cold to keep nerves busy transmitting those sensations instead of pain chili-pepper-derived capsaicin or cooling menthol , or by numbing the area lidocaine.
Prescription Drugs Antidepressants. But for years, doctors have prescribed other antidepressants off-label. Small doses can help with fibromyalgia, headache prevention, and pain due to nerve damage. But they can come with side effects, such as weight gain, constipation, and suicidal thoughts.
Three drugs used to prevent seizures are also FDA-approved—and increasingly prescribed—for certain types of nerve pain: gabapentin Neurontin and generic , pregabalin Lyrica , and carbamazepine Epitol and generic , which can cause deadly allergic reactions. Studies suggest they help with nerve pain but not common ills such as back pain. Side effects can include suicidal thoughts. Muscle relaxants. Drugs such as cyclobenzaprine Amrix and generic can be useful against a pain flare-up.
Avoid carisoprodol Soma because it carries a high risk of abuse and addiction. And never take these alongside opioids. These drugs—which include codeine, oxycodone OxyContin , and hydrocodone, and are sometimes combined with acetaminophen Vicodin, Percocet —should be considered only if no other treatments work and only if there are more benefits than risks for an individual patient, according to the American College of Physicians.
They work well in the short term for severe pain from an injury or from surgery but not against chronic pain because they often lose effectiveness over time, can increase sensitivity to pain, and carry risks of addiction and overdose. Possible side effects include constipation, breathing problems, confusion, irritability, and sedation.
Five years ago, Austin Kessler of Driftwood, Texas, was lifting a rock in his yard when he heard a loud pop. It was his back, and he fell to the ground in excruciating pain. The year-old suffered a herniated, or slipped, disc. His primary care doctor referred him to an orthopedist, who recommended surgery. After a second opinion, Kessler decided against surgery, and his pain abated over time with physical therapy and exercise.
Acute pain: How to treat and manage in infants and toddlers
This is not uncommon. Orthopedic surgery has more people seeking second opinions than any other specialty, according to one study of thousands of patients. More than a third of these second opinions lead to a change in treatment plan. Surgeries and injections do help in certain cases.
But they carry more risk than most other treatments, so you should generally seek a second opinion if a doctor is pushing surgery, says David Hanscom, M.
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