- •This article highlights one approach to evaluate upper extremity pain in children to help identify those with or at risk of, chronic pain.
- •A detailed description of how to map sensory thresholds and sensory disturbances is provided.
- •Recommended outcome measures for self-reported pain intensity, location, descriptors, and interference are discussed.
Hand surgeons and therapists play an important role in the early identification of children at risk of developing chronic or recurrent pain after an upper extremity injury. Early identification of children at risk of developing a pain syndrome is critical because their physical, psychological, and/or social functioning may decline quickly without proper management due to the multidimensional nature of pain.
Purpose of the Study
This article outlines one approach to evaluating upper extremity pain in children to help identify those with, or at risk of, chronic pain.
An assessment framework that recognizes the biological, sensory, emotional, and psychosocial components of pain is described.
The key components of a screening evaluation include obtaining a detailed history and a thorough physical examination that involves: systematic upper extremity mapping of sensory thresholds, mapping of sensory disturbances, and screening of self-reported pain intensity, location, descriptors, and interference.
Discussion and Conclusion
The evaluation approach described will enable hand therapists to identify children with upper extremity pain that are at risk of developing a chronic pain and make an early referral to a multidisciplinary pain team that provides education, pharmacological pain management, physical rehabilitation, and psychological treatments.
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JHT Read for Credit
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The purpose of the article is describe a method to
- a.prevent chronic pain in at risk children
- b.identify children at risk to developing chronic pain following injury
- c.treat pain in at risk children
- d.identify the roles of surgeons, OTs, and PTs in treating at risk children
- #2.The authors anticipate the management of chronic pain will include
- b.physical rehab
- c.patient psychological counseling and education
- d.all of the above
- #3.The authors recommend managing the pain by
- a.referral to a psychologist specializing in upper extremity pain
- b.the same staff who performed the initial evaluation
- c.referral to a multidisciplinary pain team
- d.referral to the nearest university children’s hospital
- #4.The effect of pain on the psychosocial and function of the child is best measured by
- a.a trained psychologist
- b.self-report instruments
- c.electrodiagnostic tools
- d.experienced CHTs
- #5.Central to the evaluation process is mapping of sensory disturbances and pain thresholds
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Accepted: February 9, 2018
Received in revised form: February 9, 2018
Received: December 16, 2017
The authors have no actual or perceived conflicts of interests.
© 2018 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.