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Intervention for Treating Chronic Pain

1. Design Descriptive, Survey Questionnaire. Purpose: To explore variables that influence chronic pain in children.

2. Setting The study will focus on pediatric patients 8 years and older seen in a hospital-based Rheumatology clinic in Arkansas. 3. Sample For this study pediatric is defined as anyone age 8 years to 15 years of age. Twenty patients will be recruited to participate in this study. Participants will be recruited at the Rheumatology Clinic in the Medical Specialties services on day qualifying patients are scheduled. A convenience sampling will be conducted within the clinic. A schedule of patients will be reviewed with the Charge Nurse. The investigator will be on-site to talk with families and explain the procedure. Parents and Patients voicing interest will be asked to complete a demographic sheet and answer questions related to the child's daily pain level, ability to complete Activities of Daily Living, and the use of any of the interventions listed below. Participants will be randomly assigned to one of two groups. Group A will be treated with Pharmacological and placed in a 12-week Physical Therapy regimen. Group B will receive Pharmacological treatment. A patient who meets the following criteria will be included in this study: Inclusion Criteria: * Age 8-15 years * Seen in the hospital-based Rheumatology clinic * Patients with a daily pain rating of 5-10 on the Numbers Scale * Patients with documented deficits in completion of Activities of Daily Living

Exclusion Criteria: * Patients unable to provide assent to the study * Caregivers and/or Patients whose primary language is not English * Caregivers and/or Patients who cannot read English 4. Intervention a. Active Ingredients (Variables)(1), (2) (1) Pharmacological Management (2) Physical Therapy and Exercise b. Rationale for Active Ingredients (1) Pharmaceutical intervention for pain relief(1); NSAIDS, methotrexate, etc. (2) (2) Assess functional activities that may be pain producing. Exercise/conditioning can improve aerobic function, mood, pain, and maintain range of motion.(1)(2)

References:

1. Landry, B., Fischer, P., Driscoll, S., Koch, K., Harbeck-Weber, C., Mack, K., Wilder, R., Bauer, B., & Brandenburg, J. (2015). Managing chronic pain in children and adolescents: a clinical review. American Academy of Physical Medicine and Rehabilitation. S295-315. http://dx.doi.org/10.1016/j.pmrj.2015.9.006.

2. Stinson, J. N., Luca, N. J., & Jibb, L. A. (2012). Assessment and management of pain in juvenile idiopathic arthritis. Pain research & management, 17(6), 391–396. doi:10.1155/2012/237258.