Stollery Clinic helps pediatric patients manage their chronic pain

As a researcher, Kathy Reid has found that patients have already seen up to nine other medical care providers to discuss their chronic pain before coming to the Stollery Pediatric Chronic Pain Clinic. As a nurse practitioner, she hopes the clinic, located at the Stollery Children’s Hospital in Edmonton, Alberta, is the final stop on their pain management journey.

Since 2008, the clinic, one of seven dedicated pediatric chronic pain clinics in Canada and the only one with a full-time nurse practitioner, has been treating and caring for children who experience chronic pain. The clinic serves patients from a catchment area that includes central and northern Alberta, the Northwest Territories, Saskatchewan and northeastern British Columbia. As part of Alberta Health Services, Calgary is home to a program which also treats children with chronic pain in southern Alberta.

Working as one unit, the interdisciplinary team is made up of a nurse practitioner, a pain specialist physician, physiotherapist, psychologist, and benefits from the support of a research coordinator. Using biological, psychological and social approaches to help patients and families manage their pain, the team addresses how pain affects a patient’s daily life such as physical function, development, school attendance, sleep, mood, family life, and activities.

More importantly, the team helps patients and families using strategies like medication, physiotherapy or exercise, and psychological interventions like cognitive behavioural therapy to improve their quality of life.

The clinic runs ongoing group cognitive-behavioural therapy sessions to educate teens about chronic pain and teach them self-management strategies. The program, called Pain 101, consists of ten 90-minute sessions. For participants outside Edmonton, the sessions are accessible via Telehealth, a provincial government initiative with over 900 videoconference sites across Alberta.

With topics including pain education, activity regulation and pacing, relaxation strategies, improving sleep, and communication, teens explore different ways to manage their pain. “Almost all teens tell us that they had never met a peer who has chronic pain,” says Reid. “They often report how helpful it is to meet someone else who is dealing with the same challenges in managing pain, someone who understands.”

Last year, the clinic saw 54 new patients in addition to patients referred in previous years. The youngest patient was four-years old. The average age of their patients is 14 years.

Unlike common ailments that affect children, like a broken bone or sore tonsils, Reid notes that chronic pain “waxes and wanes but rarely goes away.” As a result, the team sees many of their patients until they reach adulthood.

However, the team knows that their approach is working when they see patients living life without being held back by pain. Reid says the greatest reward is when a patient tells them about reaching a new milestone like returning to school, graduating, or becoming engaged.

Another measure of success is the positive feedback from parents. For parents whose children experience chronic pain, the lack of supports and information about their child’s condition can cause a great deal of stress and frustration.

Based on her research, Reid offers classes to provide parents with the supports and information they need. “Parents tell us they feel supported and they appreciate that their child’s concerns are valued and acknowledged by the team,” she says. “It’s a great feeling to know we’re helping them get their lives back.”

One parent says: “Once my daughter was assessed through the Chronic Pain Clinic and her pain was validated, the stress levels went down as a huge weight was lifted from me and my daughter.  We finally found some hope in a medical system that we started to question from every angle.  Since the original assessment, my daughter has enrolled in Pain 101 and so far through this course she is not only learning how to live with her pain, but she has finally discovered that she is not alone in her struggle.”

In 2011, Reid received the Canadian Pain Society Award for Nursing Excellence in Pain Management. The award is presented annually to a nurse who consistently exemplifies leadership in an area of nursing practice, education, or research in pain management.  Reid says she was honoured to be recognized, especially since she was nominated by her peers, but is quick to point out that it’s a team effort – “I feel very fortunate to work with such a great team.”