Recognizing and managing chronic musculoskeletal pain in childhood

Many young people have occasional musculoskeletal pains that are self-limiting and without consequence. A small number, however, do develop persistent pain that has significant impact on activity and lifestyle. It is important to recognize these pain conditions as early as possible to optimize rehabilitation and outcome. Medication has a role when part of a multidisciplinary framework, although there is little evidence for or against the effectiveness of most pharmacotherapy in children. There is strong evidence to support early targeted psychological and physical intervention, and an understanding that parental education and involvement is essential if progress is to be maintained. Here the different presentations of pain conditions and aspects of rehabilitation are discussed.