Pain Management
Pain Management Clinic

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Comprehensive Care for Pediatric Pain Conditions

The Pain Management Clinic at Cincinnati Children’s is nationally recognized for its expertise in the diagnosis, treatment, research and education of complex pediatric pain conditions.

The Pain Management Clinic at Cincinnati Children’s provides outpatient care for children and young adults who are experiencing chronic and recurrent:

    • Abdominal pain
    • Back, chest and extremity pain
    • Headache
    • Complex regional pain syndrome (reflex sympathetic dystrophy)
    • Pancreatitis
    • Fibromyalgia
    • Nerve pain caused by an injury or resulting from toxic or genetic causes
    • Joint pain caused by Ehlers-Danlos syndrome, juvenile rheumatoid arthritis and other conditions
    • Pain from cerebral palsy; sickle cell disease; epidermolysis bullosa and severe eczema; and metabolic and hereditary diseases
    • Pain-related mental health conditions or symptoms, such as depression or anxiety

Visiting the Clinic

This clinic’s pain management team takes a holistic approach to care, looking closely at all aspects of a patient’s condition and how it affects his or her quality of life, school experience and family relationships. Led by board-certified physicians who specialize in chronic pain management, the team includes advanced practice registered nurses, physical therapists, behavioral medicine specialists and psychologists. They communicate with others who are involved in the child’s medical care, including specialists and primary care physicians.

During their first visit to the clinic, patients undergo a comprehensive evaluation by the advanced practice registered nurse, who becomes their primary point of contact at the clinic. After the initial evaluation, the team develops a personalized treatment plan and shares it with the patient and family. The plan can include:

    • Medication
    • Behavioral Medicine techniques to help control pain and reduce pain-related stress
    • Physical therapy exercises to improve strength and function and reduce pain
    • Nerve blocks and other procedures
    • Recommendations for aquatic therapy, acupuncture, yoga, massage
    • A referral to the Inpatient Pain Rehabilitation Program 

Our advanced practice registered nurses also help patients and families better understand their condition, manage their medications and side effects and deal with pain-related challenges at home and at school.

Information for Healthcare Professionals

Our specialists take a holistic approach, evaluating each patient’s situation from a medical, psychosocial and emotional perspective before developing a pain management strategy unique to the child’s needs. Many treatment regimens can take place close to home under the care of the child’s referring physician. For pain-related disability that requires intensive treatment, we collaborate with our colleagues in Rehabilitation Medicine to provide comprehensive inpatient pain management at the hospital.

Pain management strategies and therapies include:  

    • Physical and occupational therapy
    • Cognitive-behavioral therapies
    • Medications
    • Transcutaneous nerve stimulation
    • Nerve blocks and trigger point injections
    • Integrative medicine, including: massage; acupuncture; martial arts; yoga; meditation
> Find contact and referral information on our Contact / Refer page

Cincinnati Children’s is a leader in pediatric pain research. As a founding member of the Pediatric Research Network for Pain, we work with other leading institutions to develop clinical trials that advance the understanding of pain and pain management therapies.

Current research initiatives include:

    • Laboratory studies to enhance our understanding of the molecular mechanisms underlying sensory neuron responses to peripheral injury. The goal is to develop new therapies for musculoskeletal pain associated with ischemia and other painful conditions.
    • Studies that focus on parental responses to chronic pain as well as child pain expression and pain behaviors.
    • NIH-funded research that explores cognitive-behavioral therapy and tailored physical therapy for patients with juvenile fibromyalgia.

    • We collaborate with the Pancreas Care Center on outcomes research for the Total Pancreatectomy Islet Auto Transplantation (TPIAT) procedure

    • Laboratory studies to enhance our understanding of the molecular mechanisms underlying sensory neuron responses to peripheral injury. The goal is to develop new therapies for musculoskeletal pain associated with ischemia and other painful conditions.

    • Studies that focus on parental responses to chronic pain as well as child pain expression and pain behaviors.

    • Studies that focus on the outcomes of intensive inpatients pain rehabilitation, as we as NIH-funded studies that aim to help us understand the nature of pain processing in the nervous system.

In addition, the Pain Management Center is one of only two ACGME-accredited pediatric pain fellowship programs in the country and is a major training site for pediatric pain psychologists. Lectures for pediatric residents, observerships for practicing physicians, and multidisciplinary pain seminars are also conducted routinely.

When should I consider making a referral to the Pain Clinic?
Primary care practitioners see the vast majority of pain complaints and manage them quite well. Occasionally, a pain condition presents itself that is perplexing, multifaceted or resistant to standard treatments. We make our services available for this subset of pain conditions. Neuropathic pain (including RSD), residual cancer pain, pelvic pain, refractory pain of long duration with high levels of disability and pain behaviors in developmentally disabled children are conditions that would warrant a referral.

How can I provide the best pain care to my patients?
As consultants, we recognize and respect the therapeutic bond between primary practitioners and their patients. We strive to forge an alliance with the practitioner to provide the smoothest, most coordinated care for our shared patients.

Communication is of the utmost importance. Therefore, you will receive a letter detailing our comprehensive evaluation after the first visit, as well as brief notes after follow-up visits. We will try to coordinate the initiation of new medications or therapies if there is any risk of interference with an existing plan of treatment.

We ask only that you do not start or stop pain-related medication without contacting us, as several medications have either drug-drug interactions or withdrawal symptoms. We have a physician on-call at all times to respond to emergency needs that arise.

Finally, we spend a fair amount of time and effort “de-medicalizing” pain. We try to reduce the emphasis on tests and procedures, once life-threatening entities have been ruled out. We ask for your cooperation in not ordering more tests, X-rays or other such things, even at the risk of irritating the patient or parents. Often, the more unnecessary tests are done, the slower the progress is.

How can I ensure a smooth referral process for my patients?
As a consulting service, we must receive a physician consultation request to receive reimbursement from most insurance companies. We request that pre-certification numbers for “pain physician, ” “physical therapist” and “psychologist” be sent along with the physician consult. Sending these pre-certification numbers will avoid delays in scheduling appointments.

Any relevant records, tests and radiological studies should accompany the initial letter. Certainly, sending copies along with the patient is helpful. We often receive a consult request that reads, in total: “evaluate and treat chronic (insert body part) pain,” which minimally serves the patient. The more relevant information we have at the time of evaluation, the better we can help the patient and primary physician alike.

Physical Therapy and the Pain Management Clinic

Learn how physical therapy can help manage pain in children.

> View more Pain Management videos

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