Clinical impact and evidence base for physiotherapy in treating childhood chronic pain.
OBJECTIVE
As part of the special series on pain, our objectives are to describe the key features of chronic pain in children, present the rationale for interdisciplinary treatment, report a case study based on our biopsychosocial approach, and highlight the integral role of physiotherapy in reducing children's pain and improving function. We also evaluate the evidence base supporting physiotherapy for treating chronic neuropathic pain in children.


CONCLUSIONS
Chronic pain affects many children and adolescents. Certain challenging pain conditions begin primarily during adolescence and disproportionately affect girls and women. Children with these conditions require an interdisciplinary treatment programme that includes physiotherapy as well as medication and/or psychological intervention. Converging lines of evidence from cohort follow-up studies, retrospective chart reviews, and one randomized controlled trial support the effectiveness of physiotherapy within an interdisciplinary programme for treating children with chronic pain.


CONCLUSIONS
Evidence-based practice dictates that health care providers adopt clear guidelines for determining when treatments are effective and for identifying children for whom such treatments are most effective. Thus, additional well-designed trials are required to better identify the specific physiotherapy modalities that are most important in improving children's pain and function.
Anne Ayling Campos, PT:  Physiotherapist, Departments of Anesthesia and Pain Medicine and Rehabilitation Services, The Hospital for Sick Children, Toronto, Ontario.
Anne
A
Ayling Campos
Khush
K
Amaria
Fiona
F
Campbell
Patricia A
PA
McGrath
D059350:Chronic Pain / Q000523:psychology; D019317:Evidence-Based Medicine; D055317:Evidence-Based Practice; D005500:Follow-Up Studies; D006801:Humans; D009437:Neuralgia; D017063:Outcome Assessment, Health Care; D059408:Pain Management; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies