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Pediatric Chronic Pain

The Pediatric Chronic Pain Program is an outpatient clinic at McMaster Children’s Hospital.

We see children and teenagers who have complex or persistent pain. We work with young people when their pain is getting in the way of their ability to participate in meaningful activities such as school, sports, or spending time with family and friends. Our program focuses on teaching youth skills and providing support, so that they can get back to the activities that are important to them.

We support children and youth when:

• They are experiencing pain that has lasted longer than 3 months. Exception: suspicion for Complex Regional Pain Syndrome (CRPS).
• Usual medications and treatments have not been helpful.
• Pain is having an impact on school, relationships, sleep, activities, and/or emotional well-being.
• They are interested in learning new skills to better manage pain.

There are many different types of chronic pain conditions in children and adolescents. Common pain conditions we see include:

• Chronic headaches
• Chronic abdominal pain
• Chronic musculoskeletal pain
• Chronic widespread pain
• Chronic pain as a result of another medical condition (e.g. Juvenile Rheumatoid Arthritis, Inflammatory Bowel Disease)
• Complex Regional Pain Syndrome (CRPS)
• Neuropathic pain
• Post surgical pain

Care We Provide

Chronic pain is complex. The best treatment uses a combination of approaches.

Following an intake assessment, patients may be offered some of the following  services as part of an individualized treatment plan:

• Education about pain
• Assessment of mental health concerns
• Physiotherapy
• Occupational therapy
• Individual counselling
• Group treatment
• Parent/caregiver group
• School collaboration
• Medication management
• Referral to intensive pain rehabilitation programs (inpatient and day patient)
• Referral to community providers

Involvement in the program is time limited. Typically, youth attend clinic appointments every week or every other week for the first 1-2 months. After that, the appointments become more spread out so patients can apply the skills they have learned.

Patient Information

The first appointment involves meeting with a physician or nurse practitioner and a social worker from our team.

Please bring the following items to this appointment:

  • Ontario Health Insurance Card (OHIP)
  • List of current medication and medications previously used (including dose/frequency) (Some families find it helpful to ask for a medication list “print out” from their pharmacist)
  • Completed questionnaires that were mailed to you (youth and family)
  • Appropriate clothing (tank top/tshirt, zip up sweater) to make the physical assessment easier
    The intake appointment is typically 2.5 hours in length. We would encourage you not to bring other children/siblings to this appointment if possible.

Frequently Asked Questions

How do I know if my referral has been accepted into the program?

All referrals received by the PCPP will be reviewed and triaged. When your intake appointment has been scheduled, you will receive a phone call with an appointment date. A package with intake forms and questionnaires will also be sent to you. Your referring physician/nurse practitioner will also be notified that an appointment has been given. If our program is not an ideal fit for your child’s condition we will notify the referring provider.

What if I cancel the intake appointment?

If you cannot attend your scheduled intake appointment time, please contact the clinic as soon as possible to reschedule. Intakes will be rescheduled at the next available intake spot in 3-6 months.

What is your cancellation policy?

For scheduled follow up appointments, please give a minimum of 24 hours notice to change or cancel an appointment. This is very helpful for us as we have many patients and families also waiting to be seen, and would like to make the best of everyone’s time.

Failure to attend 2 scheduled appointments without notifying our clinic may result in closure of your file. Repeated cancellations and rescheduling may also result in closure of your file.

Team Members

The Pediatric Chronic Pain Program is run by an interdisciplinary team. This means that clinicians from different health care professions work together to provide the best care.

Our interdisciplinary team includes:

• Adolescent medicine physician
• Anaesthesiologist
• Administrative staff
• Child life specialist
• Nurse practitioner
• Occupational therapist
• Pharmacist
• Physiotherapist
• Psychiatrist
• Psychologist
• Social worker

Referral Process

Patients can contact the clinic at 905-521-2100 ext. 73049 to book follow up appointments with our business clerk. New patients will be contacted by phone and mailed a letter with date and time of their first appointment.

Referral Form – Pediatric Chronic Pain (Children’s)

Resources

The following websites have helpful information for youth with chronic pain and their families:

https://www.mycarepath.ca/
https://www.aboutkidshealth.ca/pain?topic=chronicpain
https://www.aci.health.nsw.gov.au/chronic-pain/painbytes

We have also found the following books to be helpful for parents and caregivers of youth with chronic pain:

  • When Your Child Hurts: Effective Strategies to Increase Comfort, Reduce Stress, and Break the Cycle of Chronic Pain. By Rachael Coakley
  • Managing Your Child’s Chronic Pain. By Tonya Palermo and Emily Law