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Orthogate
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Toronto, AL M5N 2M7
Ph: 416-483-2654
Fax: 416-483-2654
christian@orthogate.com






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Our daughter has had severe migraine headaches since she was three years old. She's 12 now and nothing we've tried has helped. We've heard there's an inpatient center where she could go for a month. They use many techniques all together to try and stop the vicious cycle of pain and disability. We would all have to go because it's a family-oriented program. Would it really be worth the cost? What if, after all that, she doesn't get better?

Many children who experience pain report that it lasts right on into their adult years. This alone would be enough reason to put your life on hold for a month and make a concerted effort to help your child. What can be done to put a stop to this early on? Studies are few and far between on this topic. That's why a recent study from Germany is so important. Children between the ages of 11 and 18 participated in an inpatient program lasting three weeks. Children in the study had moderate-to-severe pain lasting more than six months. Their parents reported school absences of at least one week out of the last four. Two-thirds of the 167 children reported headache pain (tension type or migraine). The pain was enough to disrupt daily activities such as homework, sleep, physical activity, and attending school. In fact, one-fourth of the group wasn’t even in school when the study began. Before entering the program, each child was tested for baseline pain intensity, level of pain-related disability, depression, and emotional distress. Number of days missed from school and number of pain relievers taken daily were also recorded. The treatment program was multimodal, meaning a wide range of methods were used. For five to eight hours every day, the children met with behavioral therapists, psychologists, art therapists, and physical therapists. They participated in individual counseling, family therapy, and group therapy. When emotional trauma was present, specific eye-movement therapy was also included. The children were required to do homework every day. They kept a journal listing what they learned in sessions each day. They practiced new techniques such as distraction, pain coping strategies, and physical exercise. Early on in the three-week program, family members were taught how to stop enabling and stop reinforcing pain behaviors. For example, they learned how to change daily routines to help support the child in going to school despite the pain. The children were not just in and out of the program. There was a transition period to help integrate the new skills at home and at school. Halfway through the three-week program, they made home and school visits to put into practice what they had learned. Relapse prevention was part of the overall program as well. Significant changes were observed in all areas measured. Half of the children taking pain medication when they came to the program were able to get off all pain relievers. Children had less pain and were able to attend school more often. Changes in emotional status were not as dramatic. School aversion and depression were less but still present in two-thirds of the group. The authors analyzed the data using age and gender (boys versus girls) as predictive factors of outcomes. Neither one of these factors appeared to make a difference in the results. The most deciding factor of overall success was level of pain. Children who started the program with lower pain levels seemed to have the best results. The authors concluded that a multimodal inpatient program aimed at the treatment of chronic pain in children and teens can be very successful. More than half were symptom-free with improved function at the end of three months' time. This was true for a variety of pain disorders. After years of suffering, that was a very positive result for those children. These findings suggest that it is possible to stop the vicious cycle of pain-disability-pain that these children experience.

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