Procedural Pain Management for Children Receiving Physiotherapy

Abstract

Purpose: This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children. Summary of key points: Physiotherapists are generally well trained in assessing and managing pain as a symptom of injury or disease, but there is a need to improve the identification and management of pain produced by physiotherapy procedures such as stretching and splinting. In contrast to physiotherapy, other health care disciplines, such as dentistry, nursing, paediatrics, emergency medicine, and paediatric psychology, produce extensive literature on painful procedures. Procedural pain in children is particularly important because it can lead to later fear and avoidance of necessary medical care. Recommendations: We emphasize the need for physiotherapists to recognize procedural pain and fear in the course of treatment using verbal, nonverbal, and contextual cues. We present many methods that physiotherapists can use to prevent or relieve procedural pain and fear in paediatric patients and provide an example of a simple, integrated plan for prevention and relief of distress induced by painful procedures.Key Words: child, pain, painful procedures, paediatric, physiotherapy von Baeyer CL, Tupper SM. Procedural pain management for children receiving physiotherapy. Physiother Can. 2010;62:327-337 RÉ SUMÉObjectif : Cet article propose un survol de la documentation relative à la pré vention et au soulagement de la douleur et de l'anxié té qui surviennent pendant des interventions de physiothé rapie, et propose des avenues en ce sens aux physiothé rapeutes qui traitent des enfants. Ré sumé des principaux points : Les physiothé rapeutes sont gé né ralement bien formé s pour l'é valuation et la gestion de la douleur en tant que symptô me d'une blessure ou d'une maladie, mais des amé liorations sont né cessaires pour l'identification et la gestion de la douleur qui ré sultent des procé dures de physiothé rapie, comme les é tirements ou les contractions. Contrairement à la physiothé rapie, d'autres disciplines de la santé , notamment la dentisterie, les soins infirmiers, la pé diatrie, la mé decine d'urgence et la psychologie pé diatrique ont inspiré une abondante documentation sur les procé dures douloureuses. Les douleurs procé durales chez les enfants sont particuliè rement importantes, parce qu'elles peuvent les amener à avoir peur des soins mé dicaux né cessaires ou à les é viter. Recommandations : Nous insistons sur la né cessité pour les physiothé rapeutes de savoir reconnaître la douleur procé durale et la peur qui surviennent en cours de traitement à l'aide d'indices verbaux ou non verbaux et contextuels. Nous pré sentons plusieurs mé thodes que les physiothé rapeutes peuvent utiliser pour pré venir ou soulager la douleur procé durale et la peur chez les patients pé diatriques et donnons aussi un exemple de plan inté gré simple pour la pré vention et le soulagement de l'anxié té causé e par les procé dur...

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