Pediatric Chronic Pain Management Strategies

Chronic pain in children and adolescents is recognised as a complex condition that extends beyond nociceptive symptoms, often resulting in significant impairment across physical, emotional and social domains. Prevalence estimates vary, but up to 25% of young people experience persistent pain that disrupts daily activities, schooling and peer relationships. Central to modern management is the adoption of a biopsychosocial model, which integrates biological mechanisms with psychological influences—such as anxiety, mood disorders and pain catastrophising—and social contexts defined by family dynamics, school support and cultural attitudes towards pain. Treatment strategies have evolved from a primarily pharmacological focus to interdisciplinary programmes that combine pharmacotherapy with physical rehabilitation, psychological therapies and integrative modalities. Pharmacological approaches emphasise judicious use of analgesics, with current guidance discouraging routine opioid prescribing for primary pain disorders and favouring non-opioid alternatives. Physical therapies incorporate graded exercises and functional restoration to counter avoidant behaviours and mitigate deconditioning. Psychological interventions, in particular cognitive behavioural therapy and mindfulness-based techniques, aim to reframe maladaptive beliefs about pain and foster active coping skills. In parallel, novel digital interventions and self-management platforms are enhancing access to evidence-based care, empowering young patients to monitor symptoms, set personalised goals and maintain engagement outside traditional clinical settings. Across all approaches, active involvement of families and school personnel is crucial to ensure coherent support networks, normalise daily function and promote resilience during recovery.

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Pediatric Chronic Pain Management Strategies publication trend

The graph below shows the total number of articles in pediatric chronic pain management strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Biopsychosocial model: A framework recognising the interplay between biological, psychological and social factors in the development and maintenance of chronic pain.

Multidisciplinary rehabilitation: Integrated treatment delivered by professionals from multiple disciplines to address the physical, psychological and functional aspects of pain.

Cognitive behavioural therapy (CBT): A structured psychological approach that targets unhelpful thoughts and behaviours to improve coping and reduce pain-related disability.

Pain catastrophising: A cognitive pattern characterised by exaggerated negative beliefs about pain, leading to heightened distress and functional impairment.

Functional disability: The extent to which pain interferes with a person’s ability to perform everyday activities, including schooling, socialisation and self-care.

References

1. Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment. Children (2016).
2. Social Functioning and Peer Relationships in Children and Adolescents with Chronic Pain: A Systematic Review. Pain Research and Management (2010).
3. Pediatric Fear‐Avoidance Model of Chronic Pain: Foundation, Application and Future Directions. Pain Research and Management (2012).
4. iCanCope with Pain™: User‐Centred Design of a Web‐ and Mobile‐Based Self‐Management Program for Youth with Chronic Pain Based on Identified Health Care Needs. Pain Research and Management (2014).
5. Best-Evidence for the Rehabilitation of Chronic Pain Part 1: Pediatric Pain. Journal of Clinical Medicine (2019).
6. Distinct Influences of Anxiety and Pain Catastrophizing on Functional Outcomes in Children and Adolescents With Chronic Pain. Journal of Pediatric Psychology (2015).
7. Evidence-Based Psychological Interventions for the Management of Pediatric Chronic Pain: New Directions in Research and Clinical Practice. Children (2017).
8. Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids. Children (2019).