Chronic posttraumatic pain in children and adolescents

Definition. Chronic pain is defined as pain lasting for more than 3 months without any acute or persisting somatic trauma. Epidemiology. The prevalence of chronic pain is continuously increasing in developed countries not only in the adult population but also in children and adolescents. Headache, abdominal pain, and musculoskeletal pain are the leading areas for chronic pain in youth. Understanding pain and its diagnosis. New findings from neurophysiology, psychology, and most of all from imaging techniques, such as functional MRI (magnetic resonance imaging) have led to a completely new understanding of chronic pain during recent years. Adolescents with chronic pain resulting from trauma will frequently develop a complex regional pain syndrome (CRPS). These patients often experience multiple diagnostic procedures and frustrating medical treatment approaches with insufficient results. Pain amplification syndromes should therefore be considered in adolescents suffering from inadequately diagnosed strong pain symptoms lasting for more than 3 months. Therapy. In specialized centers, such as in Garmisch-Partenkirchen or Datteln, in-patient multimodal therapy established for children and adolescents is successful in most cases.