Study published in Pediatrics encourages pediatricians to treat the cause of pain, not the symptoms
Even Dr. Darcy Fehlings, the principal investigator on a study examining pain in children with cerebral palsy (CP) was surprised by her team’s findings; over 25 per cent of children with CP have moderate to severe chronic pain that limits their daily activity.
“This study clearly showed us the extent to which children with cerebral palsy experience chronic pain,” says Dr. Fehlings. She says health-care providers have long been concerned that they were missing pain in children with CP, but lacked data showing pain prevalence.
Dr. Fehlings, Physician Director of the Child Development Program at Holland Bloorview Kids Rehabilitation Hospital and Clinician Senior Scientist at the Bloorview Research Institute, published the findings of her study in the health journal Pediatrics.
CP is the most common neurodevelopmental physical disability, occurring in 2 – 2.5 out of every 1000 live births in developed countries. Dr. Fehlings, who leads the Cerebral Palsy Discovery Lab at the Bloorview Research Institute, aimed to better understand the prevalence and impact of pain on children and youth with CP.
Her study tracked the physician-diagnosed cause of pain, and found that hip pain and increased muscle tone were the most common causes. Dr. Fehlings is optimistic about how her findings can be applied. “This knowledge will allow pediatricians to focus on accurately assessing and managing the root cause of this pain.”
Cameron Purdy is a 13 year old boy with cerebral palsy. He and his mom Corinna have been long-time Holland Bloorview clients working with Dr. Fehlings; Corinna even lived at Holland Bloorview for three months in 2009 while Cameron recovered from a surgery.
Corinna Purdy is glad to see the Bloorview Research Institute looking at chronic pain in kids with CP. “It can be hard for kids to explain where the pain is, especially if they’ve lived with pain their whole life. Maybe they think it’s normal, or maybe they are too shy to tell you – either way, you may not know they’re in pain. Dr. Fehlings used cartoon faces instead of a one-10 pain scale, which helped Cameron communicate his pain levels.”
Dr. Melanie Penner, a Fellow in Developmental Pediatrics at Holland Bloorview working with Dr. Fehlings, says Cameron and Corinna’s experience is typical. “This study has underlined the importance of asking every child with CP about their pain levels. This can sometimes pose a challenge for children with communication limitations, which makes a systematic pain assessment plan crucial.”
Dr. Fehlings is hoping to share her findings with as many physicians and parents of children with CP as possible. “Developing a strategy to prevent, assess, and manage chronic pain for kids with CP is key to improving their health and quality of life.”
Holland Bloorview is Canada’s largest children’s rehabilitation hospital, fully affiliated with the University of Toronto. We pioneer treatments, technologies, therapies and real-world programs that give children with disabilities the tools to participate fully in life. Every year, we see about 7,000 children with about 600 inpatient admissions and 58,000 outpatient visits. The Bloorview Research Institute The Bloorview Research Institute is the only hospital-embedded pediatric rehabilitation institute in Canada. Established in 2004, the internationally recognized Bloorview Research Institute is dedicated to improving the lives of children with disabilities through client and family-centred rehabilitation research.