Treatment of chronic pain in children and adolescents with psychomotor handicaps

Parents of children with severe psychomotor handicaps report that their children are often not effectively treated for pain. Scientific investigations confirm the lack of pain therapeutic care of children with psychomotor handicaps. Affected children and adolescents receive less postoperative pain medication. The worse the handicap, the less strong pain medication (opiates) is provided.

In order to ascertain how effective pain therapy is, pain must first be measured and then compared. This is incomparably difficult in children with severe psychomotor handicaps, as communication is severely limited and therapists have only non-verbal utterances to go by. Pain is a subjective symptom and can only be assessed with the child. Special pain measuring instruments requiring expert use and analysis require specialized knowledge and experience.

Pain therapy can only be successful if based on a carefully checked medical assessment.

Appropriate treatment of chronic pain in children and adolescents with severe psychomotor handicaps requires:

• Knowledge of the biopsychosocial causes of pain
• Pediatric pain therapists with pharmacological knowledge of the peculiarities of these children

and should as a rule only be carried out by a multiprofessional inpatient team.

Invasive surgical interventions for the treatment of chronic pain in children and adolescents with severe psychomotor handicaps can as a rule be avoided.