Chronic Pain

Chronic pain, defined as pain lasting or recurring for more than 3 months, has multiple etiologies. With a rising prevalence of chronic pain in the pediatric and adolescent population, the number of young adults transitioning to adult providers with chronic pain is also rising. Many of these patients will present to adult providers with tolerance to pain medications or with pain that has been sub-optimally managed throughout childhood. Performing a multidimensional assessment of a patient’s pain etiologies and their impact on their physical, functional, and psychosocial health is a part of creating a comprehensive pain management plan for patients. In addition, understanding a patient’s prognosis and using shared decision-making while trialing therapies and managing expectations in pain control can give both patients and providers the best opportunity for success. Pain management techniques can include both pharmacologic and non-pharmacologic therapies such as physical therapy and mindfulness. Special considerations should be made in transitional care to adulthood, especially in patients with verbal or cognitive deficits affecting their ability to verbally communicate. Ongoing awareness and monitoring for comorbid mental health conditions, addiction, or dependence should be done periodically. Tools exist for both patients and providers.