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Interdisciplinary Pain Management Improves Pain and Function in Pediatric Patients with Chronic Pain Associated with Joint Hypermobility Syndrome
Author(s) -
Revivo Gadi,
Amstutz Diane K.,
Gag Christine M.,
McCormick Zachary L.
Publication year - 2019
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2018.06.018
Subject(s) - medicine , physical therapy , joint hypermobility , psychosocial , chronic pain , anxiety , pain catastrophizing , population , depression (economics) , psychiatry , environmental health , economics , macroeconomics
Background The relation between chronic musculoskeletal pain and joint hypermobility in a small percentage of the pediatric population is well described. However, literature discussing the treatment of chronic pain associated with joint hypermobility in pediatrics is limited. The present study examines the impact of interdisciplinary treatment on chronic pain in pediatrics with joint hypermobility syndrome. Objective To determine if pediatric patients with chronic pain related to joint hypermobility can be effectively treated with an intensive, interdisciplinary pain management program, as measured by changes in pain, psychosocial and physical functioning, as well as parental coping. Design Retrospective cohort study. Setting Urban academic tertiary intensive outpatient interdisciplinary pain management clinic. Participants The study involved 30 patients who met the criteria for a diagnosis of joint hypermobility and chronic pain and completed an interdisciplinary pain management program. Intervention All patients were treated in an intensive pediatric interdisciplinary pain management program for a duration of 6 to 8 weeks. The program provided physical therapy, occupational therapy, psychological counseling, and weekly pediatric rehabilitation medicine follow‐up. Main Outcome Measures Outcome measures included numeric rating scale pain scores, the Bath Adolescent Pain Questionnaire, and the Bath Adolescent Pain‐Parent Impact Questionnaire. Changes from pre‐ to post‐treatment were analyzed using paired‐samples t tests. Results Patients endorsed pre‐ to post‐treatment improvements in pain, depression, general anxiety, pain‐related anxiety, social functioning, and physical functioning ( P < .05). The patients' parents showed significant improvements in depression, anxiety, catastrophic thinking, self‐blame and helplessness, leisure functioning, and parental behavior ( P < .05). Conclusion The present findings suggest that an intensive interdisciplinary rehabilitation pain management program yields short‐term improvements in pain, emotional and physical function, and daily activity in a pediatric population diagnosed with joint hypermobility. Parents also experienced benefits from the program. A larger prospective study with longer‐term follow‐up is needed. Level of Evidence III