Pain in Children With Cerebral Palsy: A Review

Kimberly A. McKearnan; Gail M. Kieckhefer; Joyce M. Engel; Mark P. Jensen; Susan Labyak

J Neurosci Nurs. 2004;36(5)

Summary

There are a number of unanswered questions regarding pain in children with CP despite clinical anecdotes suggesting that pain is a significant problem for these children. Though treatment approaches are beyond the scope of this review paper, many are available, including a multitude of pharmacological interventions specific to each problem or complication as well as nonpharmacological interventions such as distraction, relaxation training, biofeedback, and therapeutic massage (McGrath, 1990). If efforts continue to understand the pain experiences of children with CP and to develop appropriate, effective pain assessment and management strategies for these children, their lives and the lives of those around them will be enhanced immeasurably.

The print version of this article was orginally certified for CE credit. For accreditation details, please contact the publisher, American Association of Neuroscience Nurses (AANN), 4700 W. Lake Avenue, Glenview, IL 60025

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Funding information

This review was supported by grant PO1 ND/NS 33988, "Management of Chronic Pain in Rehabilitation," from the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke, National Institutes of Health.

Cite this: Pain in Children With Cerebral Palsy: A Review - Medscape - Oct 01, 2004.

Table 1. Common Potential Contributors to the Experience of Pain in Children with CP
Surgical	Procedural	Gastrointestinal
Selective dorsal rhizotomy Soft tissue releases Tendon lengthening Capsulotomy Fasciotomy Osteotomy Tenotomy Spinal fusion Pump implantation for intrathecal baclofen adminstration Fundoplication Gastrostomy tube placement	Intramuscular and other medication injections Adminstration of anesthesia Blood draws Placement of a nasogastric tube Dental procedures Enemas	Gastroesophageal reflux Nausea/vomiting following surgical procedures Gastrostomy tube-related pain or infection Abdominal pain
Orthopedic	Neuromuscular	Rehabilitative
Hip subluxation/dislocation Cephalad displacement of the patella Equines of the ankle Valgus deformities of the ankle Varus and valgus deformities of the foot Radial subluxation/dislocation Cartilage degeneration scoliosis Pelvic obliquity Kyphosis Ordosis Contractures Degenerative arthritis	Spasticity Overuse syndromes Nerve entrapments Radiculopathies Myelopathies Contractures	Range of motion Home exercise programs Strengthening Electrical stimulation Functional mobility training Participation in activities of daily living Splinting and orthotic fabrication and follow-up Serial casting Training for use of adaptive equipment Utilization of standing frames and other positioning devices

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Pain in Children With Cerebral Palsy: A Review

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