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Pain Medicine

Treatment Approaches

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In the Pain Medicine program at Seattle Children’s Hospital, we take a team approach when we assess and treat pain problems. Our team of experts includes anesthesiologists, nurses, psychologists and physical and occupational therapists. Your child may see many team members during their first visit and at follow-up visits.

Chronic pain or recurrent pain may be complex. We go out of our way to learn about how your child experiences pain. Based on your child’s needs, we may suggest one or more of the evidence-based treatment approaches on this page.

Pain Medicines

When used with care, pain medicines are safe and they decrease pain. The amount of pain medicine used depends on your child’s weight, type of pain and health.

Medicine for mild pain is most often given by mouth. We often use acetaminophen (Tylenol) (PDF) or ibuprofen (Motrin, Advil) (PDF) for mild pain. They work very well to control pain, even after surgery.

For moderate or severe pain, we may prescribe a stronger type of pain medicine: opioids (PDF) like morphine or oxycodone. (We may use these along with acetaminophen or ibuprofen.) These medicines can be given by mouth. We may also give them through a line in your child’s vein.

We sometimes use more than one medicine to prevent and treat pain. Talk with your child’s team about which medicines work best for your child. Some pain medicines – even those you can buy without a prescription – may not be safe with some other medicines or for children who have certain health problems. Make sure your child’s team knows everything your child takes – medicines, supplements or other remedies (such as herbs) – so we can check whether any item might interact with your child’s pain medicine.

It is very, very rare for children to get addicted to pain medicine. Children can become tolerant to pain medicine, which means they need more medicine to get the same relief, but this is not addiction. If you have any worries about your child taking pain medicine, let your child’s team know.

Patient-controlled analgesia

This method gives pain medicine through a line in your child’s vein (an intravenous line, or IV). A pump sends the medicine into the line when your child pushes a button. The dose depends on your child’s weight and health. The pump has safety features to prevent children from getting too much medicine. Children as young as 7 years old can use this method. Read more about patient-controlled analgesia (PDF).

Epidural analgesia

This method gives pain medicine through a tube (catheter) in the space around your child’s spinal cord (epidural space). This puts the medicine right where it works without going throughout the entire body. A pump can send a steady dose of medicine all the time, or the patient can control it, like the pump described in the previous paragraph. When the patient controls this form of pain relief, it is called patient-controlled epidural analgesia. Read more about epidural catheters (PDF).

Peripheral nerve continuous infusion

We have several methods to send numbing medicine (local anesthetic) near a nerve that carries pain signals, rather than through your child’s veins or into your child’s epidural space. Peripheral nerve continuous infusion uses a small pump to slowly send local anesthetic through a tube (catheter) placed near the nerve of a painful site, such as a surgery site or a wound. Read more about peripheral nerve continuous infusion (PDF).

Continuous IV analgesia

For children who are too young or too ill to get medicine by pushing a button, we may use an IV line that gives medicine at a set rate. The dose depends on your child’s weight and health. Your child’s team can increase or decrease the rate based on assessing your child’s pain.

Cognitive-Behavioral Approaches

Many children may learn methods to help control their own pain and its impact. Psychologists often teach these methods, tailored to your child’s needs.

Self-regulatory strategies

Children can use many methods to distract themselves from pain or change their pain experience. This may include lowering or getting rid of the pain. These methods include breathing techniques, muscle relaxation, guided imagery and self-hypnosis.

Coping and problem solving

Often, children with pain need to learn ways to adapt and do regular activities even though they have pain. This is most true for children with chronic or recurrent pain. Rather than being victims of their pain, they can use methods to cope with challenges and solve problems. We teach these methods along with using other treatment approaches that may help with your child’s condition.

Physical Approaches

Physical and occupational therapists provide treatments to help children rehabilitate injured or painful sites. Treatments may include building strength, stretching, bearing weight with the body part that’s healing, and using methods that change the way the nervous system interprets pain (desensitization). Therapists also use other methods to reduce pain, like transcutaneous electronic nerve stimulation (TENS), ultrasound, heat and cold.

Complementary and Integrative Medicine

Members of the Pain Medicine team at Seattle Children’s offer complementary and integrative methods, such as acupuncture or acupressure, to help deal with pain and other symptoms.