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| Format: | Recurso digital |
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Zenodo
2018
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| Online Access: | https://doi.org/10.1007/s40674-018-0101-7 |
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Table of Contents:
- <p>Purpose of review We review the prevalence of pediatric chronic musculoskeletal pain, the<br>clinical need, the evidence for pharmacological, psychological, physical and, complementary<br>approaches to pain management, and the possible future development of interdisciplinary<br>and distance care.<br>Recent findings We summarize the Cochrane Systematic Reviews on pharmacological<br>interventions, which show a lack of evidence to support or refute the use of all classes<br>of medication for the management of pain. The trials for NSAIDs did not show any<br>superiority over comparators, nor did those of anti-depressants, and there are no trials<br>for paracetamol, or of opioid medications. There are studies of psychological interventions<br>which show promise and increasing support for physical therapy. The optimal approach<br>remains an intensive interdisciplinary programmatic treatment, although this service is<br>not available to most.<br>Summary 1. Given the absence of evidence, a program of trials is now urgently required to<br>establish the evidence base for analgesics that are widely prescribed for children and adolescents with chronic musculoskeletal pain. 2. Until that evidence becomes available,<br>medicine review is an essential task in this population. 3. We need more examples and<br>efficacy evaluations of intensive interdisciplinary interventions for chronic pain management,<br>described in detail so that researchers and clinicians can unpack possible active<br>treatment components. 4. Online treatments are likely to be critical in the future. We need<br>to determine which aspects of treatment for which children and adolescents can be<br>effectively delivered in this way, which will help reduce the burden of the large number<br>of patients needing support from a small number of experts.</p>