Today's guest blogger is Katherine S. Salamon, PhD, who directs the Integrated Pain and Wellness Program at Nemours/Alfred I. duPont Hospital for Children, Wilmingtion, DE.

Many children and teens experience chronic pain that disrupts their daily lives. A variety of factors – physical, psychological and social – are linked to chronic pain in kids. When not addressed, they can give rise to negative thoughts and beliefs, such as "I'll never get better" or "I'm weak." When pain persists over time, kids may avoid participating in daily activities for fear of increased pain or injury. All of these factors can fuel and maintain the pain cycle. The most common chronic pain symptoms in children and adolescents include stomach pain, joint pain, back and leg pain, sports-related pain, and chronic headaches.

As a licensed psychologist with an expertise in pain, I lead the treatment team at Nemours, which also includes physicians, physical and occupational therapists, and other providers. The teams' philosophy in treating kids with chronic pain is to promote wellness and help them return to everyday participation and functioning at home, at school, and at play. Treatment focuses on education about pain, healthy lifestyle choices, relaxation, problem solving, goal setting, school reintegration (if needed) and identification of thoughts associated with the pain cycle.  For example, many parents and youth don't realize how tense muscle can contribute to pain or know how to relax any tension present.  A goal would be to help youth learn about pain triggers and how to manage daily activities in the context of those triggers.

Parents of children with chronic pain can help by supporting healthy habits for the whole family. That means everyone (not just the child with pain so she or he doesn't feel singled out) should drink enough water, get enough sleep, eat a healthy diet with plenty of plant-based food (and limited caffeine, salt and sugar), and exercise daily. Generally, we recommend eight hours of sleep, eight glasses of water, five or more servings of fruit and vegetables and at least 60 minutes of physical activity a day. Remarkably, just by adopting these behaviors, many kids (and adults) feel better.

For kids who need more help to manage pain, it's important to tailor treatment to each youth, using the results of a professional evaluation while taking the family's preferences into consideration. Treatment may include medication, physical and/ or occupational therapy, group therapy, biofeedback, yoga, massage, meditation and relaxation techniques. These practices focus on improving lifestyle and coping skills, reducing stress and lowering trigger levels to ease and prevent symptoms.

Medication is successful in treating some, but by no means all, patients with chronic pain. For parents of kids with chronic pain, seek an assessment that covers all the bases - physical, psychological and social -  and be prepared to invest the time it takes to help your child or teen recover fully.

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