Pain management

Chronic / Persistent Pain Syndrome

It is normal to feel pain at times; your body feels pain as a warning signal to tell you that something is wrong.

For example:

• damage e.g. a cut foot
• illness e.g. flu
• pain while the body is healing after an injury e.g. a broken leg.

As the harm to your body heals, the pain fades and goes away. The pain is there to warn you to be careful about using this part of your body, to not use it and look after yourself. We call this acute pain.

Acute pain is important and useful, as this is your body's protective mechanism to warn you that there is something wrong and to keep you safe and well.

Chronic or Persistent Pain Syndrome is when your body's protective mechanism has got things a little wrong. It is where the pain stays, even though there is no longer an injury, illness or healing going on. Sometimes it is possible to have chronic pain that starts even though you have not had an injury or illness.

Examples of chronic pain

Sarah fell over playing hockey and bruised her leg six months ago: the bruises have healed but it is still painful. She finds it difficult to walk and sometimes uses a wheelchair.

She has seen many doctors, physiotherapists, had an X-ray, CAT scan and MRI. She has been told that although she has pain there is 'nothing wrong' with her leg.

Dan loves to play football and see his friends: however, a year ago, he had a sickness bug for a few days and was unable to eat, so couldn't play football or see his friends. He recovered from the sickness bug but the pain in his tummy stayed and he has been unable to go out to play, see friends and he misses a lot of school.

He has had lots of medical investigations but all the doctors say they can't find anything wrong with his tummy even though he still has pain.

When someone has Chronic / Persistent Pain Syndrome it is common:

• for medicine / pain medication not to work
• to see lots of doctors and have lots of examinations
• for scans (X-ray, CAT, MRI) to show up as normal, as if there is nothing wrong
• for the pain to be in one place, several places or all over the body
• for the pain to change, throughout the day, or from day to day
• for people not to understand what it is
• to feel sad and worried about having Chronic / Persistent Pain.

The symptoms and intensity of chronic pain are different for everyone. Chronic pain affects many aspects of daily life.

Within Chronic / Persistent Pain Syndrome there are some different types of pain, such as:

• Complex Regional Pain Syndrome (CRPS)
• Widespread pain
• Abdominal pain
• Musculoskeletal pain
• Headaches.

Oxford Centre for Children and Young People in Pain (OxCYP)

Paediatric Chronic Pain Team

The role of the Paediatric Chronic Pain Team is to help the children / young people and families to manage their chronic pain so they can return to most or even all activities of daily living.

The team comprises:

• Consultant
• Occupational Therapist
• Physiotherapist
• Psychologist
• Teacher
• Therapy Assistant

The team will work with you to help you understand your chronic pain and slowly to get back to doing all the things that have been affected.

This could involve:

• hydrotherapy
• talking about feelings
• sorting out sleep problems
• helping school to understand Chronic Pain Syndrome and how to support you.

Each rehabilitation treatment programme is put together individually to make sure it targets the right things and is the right pace for you.

Most children / young people find the rehabilitation programmes hard work and challenging, but really helpful and fun - and most do really well.