Pain Management in Children During the COVID-19 Pandemic

Abstract

Purpose of Review For many children, the SARS-CoV-2 pandemic has impacted the experience and treatment of their pain. This narrative review draws from the pain literature and emerging findings from COVID-19 research to highlight potentially meaningful directions for clinical consideration and empirical inquiry in the months and years to come. Recent Findings COVID-19 has been linked to diffuse acute pains as well as chronic pain sequelae. Contextual factors known to increase vulnerability for pain and associated functional disability have been exacerbated during the pandemic. Beyond these salient concerns has been the remarkable resilience demonstrated by patients and providers as healthcare systems have sought to harness creativity and innovative digital solutions to support optimal child wellbeing throughout this crisis. Summary Ongoing research is needed to elucidate the short-and long-term effects of the pandemic on children's pain and to consider how the delivery of treatment via digital technology has impacted existing paradigms of pain management.

Chronic Pediatric Pain and Mental Illness During the COVID-19 Era: A Case Report From Inpatient Child Psychiatry Unit

“…Multimodal approaches to pediatric pain management have been shown to have reduced side effects compared with a single method. In addition, interdisciplinary approaches have been shown to be the most effective for managing chronic pain [16]. We also found that learning coping skills such as guided imagery, progressive muscle relaxation, and mindfulness-based learning were extremely helpful in managing chronic pain in our patients.…”

“Working Together”: Perspectives of Healthcare Professionals in Providing Virtual Care to Youth with Chronic Pain during the COVID-19 Pandemic

“…Beginning in March 2020, the world saw pediatric pain management clinics abruptly changing their delivery of care owing, in part, to social-distancing requirements. Depending on the location, some healthcare professionals (HCPs) were unable to see patients for varying periods of time because of clinic shutdowns or redeployment, whereas others were able to rapidly pivot to a virtual model of care delivery [ 11 , 12 , 13 ]. Fortunately, across Canada, all 13 pediatric pain clinic sites were able to successfully transition to virtual care, where the largest program in Canada (The Hospital for Sick Children) transitioned over the course of 2 weeks at the onset of the pandemic [ 11 , 14 ].…”

“…Further, given that the optimal paradigm for chronic pain management involves psychological, physical, and pharmacological approaches, the transition from in-person care to a full-scale virtual model was no easy feat [ 15 , 16 ]. Multidisciplinary treatment (MDT) teams consisting of physicians (e.g., anesthesiologist, pain doctor, or pediatrician), physical therapists, nurse practitioners, psychologists and/or psychiatrists, occupational therapists, and/or social workers began to rapidly navigate virtual technology to ensure that patients received safe and quality care [ 13 , 17 ]. While some HCPs had prior knowledge of and practice delivering occasional telemedicine appointments, very few had experience delivering full-time remote services (e.g., videoconference, telephone consultation) [ 12 , 18 , 19 ].…”

Evaluating Telehealth Implementation in the Context of Pediatric Chronic Pain Treatment during COVID-19

“…In the early weeks of the COVID-19 pandemic, virtually-delivered care transitioned from being an innovative service delivery method to an essential healthcare platform. Providing healthcare using telehealth enabled pediatric chronic pain clinics to increase patient and staff safety while ensuring continuity of care [1,2]. The expansion of telehealth was further supported by state and federal policy changes, including the Medicaid telehealth expansion, that lifted telehealth restrictions and established parity in reimbursement…”