Many physicians do not understand the complex nature of chronic pain. Whereas patients with acute pain improve fairly predictably and rapidly, chronic pain patients often do not. Physicians may become frustrated because chronic pain appears to lack any identifiable biological purpose, and they see no consistent correlations among physical variables, pain perception, and disability, despite the fact that these patients present with pain behaviors and are often not working, attending school, or leading functional lives.
In the course of their treatment, many pediatric patients with chronic pain go several months with undertreated pain or ineffective treatments. These patients often lose hope and exhibit anxiety and depression that affect their daily life, social functioning, and education. Social, psychological, and environmental factors affect chronic pain (J Pain 2010;11:1039-46; Pain 2007;131:132-41; Pain 2012;153:437-43; J Pediatr Psychol 2009;34:882-92; Pain 2008;138:11-21). The patient may be unaware of these factors,...
