The interdisciplinary management of pediatric pain: Time for more integration

Chronic pain in children is overwhelmingly prevalent and is recognized as a major health concern in this population. A biopsychosocial model has been essential for understanding and treating chronic pain in children for decades through interdisciplinary or multidisciplinary pain programs, with results showing a trend for favorable outcomes. However, despite this trend, there remains a subset of patients who continue to have pain issues and disability that prevents full recovery to an optimally functional life. With our increased understanding of central sensitization, the underlying mechanism that promotes chronic pain, we need to target interventions that will calm and balance the nervous system. With expanded use of nutritional therapies that can reduce inflammation and complementary and alternative medicine modalities that have “centrally acting” nonspecific actions, many of these children may have resolution of symptoms and an improved quality of life. An integrative approach to pain management is particularly applicable in children as it seeks to have a full understanding of the underlying problem, promotes partnership with the patient and the family, and uses evidence-based medicine to employ all appropriate therapeutic approaches, both conventional and alternative.