Do you treat the pain or the dysfunction?

We do not treat the pain directly but focus on function. Most children, once function is restored, will lose their pain as a byproduct. There are children who will have long lasting pain and still have to live normal lives so will have to learn to cope with their pain in order to make it through the day and achieve their life goals. There are some treatment programs that expect all their patients to continue to have pain, so they focus on coping with pain, doing light activities, and life goal modification. While not achieved 100% of the time, total pain resolution should be the goal of every child with any form of amplified pain. We remain optimistic that a child will become fully functional and resolve all symptoms as this is what we experience in the majority of the cases we see. Even if they continue to have pain, virtually all the children who go through this program become fully functional unless they have prolonged conversion symptoms.

Children with amplified pain have varying degrees of physical dysfunction. Some are totally incapacitated and some are still going to school and participating in sports. Intense physical and occupational therapy programs address whatever deficits are at hand. If they cannot dress themselves, then dressing is the initial functional goal. If they cannot finish a soccer game, then we work more on strength and endurance. Every child is different and the program needs to be individually tailored to the child’s needs. Strength and endurance are common to all treatment programs. And in those with allodynia (tenderness to light touch) or other sensory pain, desensitization is also a significant portion of the program.

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