title: Persistent pain in chronically ill children without detectable disease activity.
abstract: Children with organic diseases may experience persistent pain in the presence of controlled disease, as evidenced by little or no measurable disease activity or inflammation. Historically, dualistic definitions of pain have informed standard diagnostic approaches to persistent pain; aggressive investigation and treatment targeting underlying disease, even in the absence of evidence indicating disease escalation. Evidence across disease populations, in children with inflammatory bowel disease, sickle cell disease, and juvenile idiopathic arthritis indicates that persistent pain in these conditions may be better conceptualized as functional in nature, potentially resulting from disordered somatosensory processing including central sensitization. Applying a biopsychosocial understanding of persistent pain and multidisciplinary functional pain management strategies may lead to improved health outcomes.
authors: Center for Child Health, Behavior, & Development, Seattle Children's Research Institute, M/S CW8-6, PO Box 5371, Seattle, WA 98145, USA.
authors: Maggie H
authors: MH
authors: Bromberg
authors: Neil L
authors: NL
authors: Schechter
authors: Samuel
authors: S
authors: Nurko
authors: William T
authors: WT
authors: Zempsky
authors: Laura E
authors: LE
authors: Schanberg
mesh_terms: D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods*