Effectiveness of pamidronate for treating intractable chronic neuropathic pain: case report of two adolescents

Neuropathic pain in children: Special considerations

Neuropathic pain is relatively uncommon in children. Although some syndromes closely resemble those found in adults, the incidence and course of the condition can vary substantially in children, depending on developmental status and contextual factors. There are some neuropathic pain syndromes that are rare and relatively unique to the pediatric population. This article discusses the array of neuropathic pain conditions in children and available treatment strategies. Data are limited by small numbers and few randomized controlled trials. Research and clinical implications are discussed.

Latest developments in the assessment and management of chronic musculoskeletal pain syndromes in children

PURPOSE OF REVIEW

As many as 25% of new patients in pediatric rheumatology clinics present with idiopathic chronic pain and recent data suggest the prevalence of these conditions is increasing. Knowledge of the latest developments in assessment and treatment is critical for providing optimal clinical care. This review summarizes advances published in the past year forwarding our understanding of chronic musculoskeletal pain syndromes in children.

RECENT FINDINGS

Research has recently focused on the impairment associated with chronic pain syndromes in children, issues impacting the diagnosis of these conditions, and the efficacy of pharmacological and psychosocial treatments. No diagnostic criteria have been developed for specific chronic pain syndromes in children; however, data from several studies substantiate the need for thorough assessment of the child and family in multiple domains. In addition, studies have expanded both pharmacologic and psychosocial treatment options for children with these syndromes.

SUMMARY

Despite a growing body of research on chronic pain syndromes in children, there are no established standards of care. Data continues to support an interdisciplinary approach for effectively assessing and managing these conditions.

Chronic idiopathic pain syndromes

In this review, we outline a rational approach to the complex problem of chronic idiopathic pain syndromes. We focus principally on musculoskeletal pain disorders and emphasize the differences between adults and children. The different nomenclatures in use are clarified and the epidemiology is examined. The key clinical findings are highlighted and different therapeutic approaches are reviewed. The evidence base for the interventions reviewed include both 'medical' and 'non-medical' approaches. Practical problems and issues are dealt with throughout the review in order to construct a pragmatic approach that the authors intend to be of everyday use to the clinician and allied health professionals.