When a Child Hurts the Whole Family Hurts
Chronic pain can be so disabling that it can prevent a child from participating in normal age-appropriate activities, such as school, social events, and sports. It also can lead to isolation and depression as the child withdraws from friends and family.
When a child suffers, the whole family suffers. Not only are you consumed with finding a way to help your child, you may be experiencing added stress due to lost work time and other disruptions to daily living.
The Pediatric Pain Rehabilitation Program at Cleveland Clinic Children’s offers hope to children and families coping with Pain Associated Disability Syndrome (PADS), even after standard therapies, surgeries and medications have been exhausted. The program is designed to help both children and families reclaim their lives.
Our program, led by Gerard A. Banez, PhD, is the first and only pediatric specialty pain rehabilitation program in the world to be accredited by the Commission on Accreditation for Rehabilitation Facilities (CARF), demonstrating our commitment to providing the highest quality services.
Our unique program, staffed by an interdisciplinary team of experts in behavioral health, medical sciences and rehabilitation, blends two weeks of intensive inpatient treatment with one week of outpatient treatment specifically tailored to meet the needs of each child’s circumstances. We also teach parents and caregivers how to support their child for the best long-term results.
What We Treat
The Pediatric Pain Rehabilitation Program at Cleveland Clinic Children's Hospital for Rehabilitation is specifically designed for children and teens whose chronic pain interferes with their normal activities.
We treat children and adolescents with:
Complex regional pain syndrome (CRPS), a complex neurological syndrome that is a major cause of disability. It is characterized by severe, burning pain, extreme sensitivity to touch, tissue swelling and excessive sweating.
Chronic headache, either migraine or tension-type. These headaches may not be caused by serious underlying disease, but they also may not respond to medications, leaving children in pain much of the time.
Chronic abdominal pain, which can be caused by a variety of digestive disorders, such as irritable bowel syndrome (IBS), and include a mixture of disabling symptoms that interfere with daily functioning.
Fibromyalgia, a complex, debilitating disorder characterized by chronic widespread pain, multiple tender points (areas of surface pain near the joints), sleep disturbances and fatigue.
Other conditions affecting our patients include chronic back pain, various types of arthritis, chronic pelvic pain, chronic leg pain and chronic diffuse pain.
What To Expect
Patients and families should plan to arrive at 8:30 a.m. on the day of admission. The first day will primarily be information gathering, assessments and evaluations. Parents typically stay through the morning of the first day as their child adjusts to hospital staff and routines. Therapists may evaluate your child while you are waiting or speaking with other staff members.
First Two Weeks
Patients are admitted to the Children's Hospital for Rehabilitation Campus to be treated on an inpatient basis. They will be evaluated by:
- Pediatric physician
- Occupational therapist
- Physical therapist
- Recreational therapist
After we evaluate each patient’s needs, we form a specific, individualized treatment plan to provide pain management.
On Saturday, please plan some activities that your child enjoys, i.e. books, movies, games, as they will have free time but may not leave the hospital.
On Sunday, as long as patients are medically stable and have no technology prohibiting it, families and patients may go out for a 6-8 hour day pass that is active and will support your child’s program goals.
End of Week 2: Discharge from Inpatient Program
Your child will be discharged on Friday of the second week to begin the day hospital program for the third week. Parents should plan to report to the unit at the end of the day Friday to complete discharge paperwork.
Children are treated on an outpatient basis during the third week. They come to the day hospital and continue the work of the first two weeks, but return to their families each evening.
Each day begins at 8 a.m. Parents should walk children into the hospital. On the first day there will be paperwork that needs to be completed and you should plan to stay briefly.
Pick up times vary throughout the week but are between 4 p.m. and 6:30 p.m.
Parent Group is held every Tuesday at 3 p.m. and every Thursday at 10 a.m. Family Meetings are held on the second Thursday of the program during the 1 p.m. hour. In addition, parents may also be asked to participate in meetings, family education, and counseling throughout their child’s stay.
We are proud of the change that we are able to bring to our patients’ and families’ lives through the Pediatric Pain Rehabilitation Program. Our results consistently show that patients’ pain and functional impairment — typically of two or more years’ duration prior to program entry — are significantly improved. Physical and social activity improve markedly too.
Children who completed the program in 2009 reported clinically significant improvements in self-reported pain severity, physical functioning, pain-specific anxiety and social functioning.
Our outcomes assessments have revealed that these gains are maintained over time. During the first three years of our program, we treated 190 adolescents (average age 15) with chronic pain and associated disabilities. Follow-up analysis revealed these clinically significant improvements:
- Upon admission. Patients averaged 3.32 missed school days per week, and parents reported an average of 2.51 missed work days per week. Surveyed parents rated their child’s pain a 6.76 on a 0-to-10 scale.
- Two years out. Patients surveyed two years after their child completed the program averaged 0.22 missed school days per week, and parents reported 0.16 missed work days. Surveyed parents rated their child’s pain a 3.79.
- Three years out. Patients surveyed three years after their child completed the program reported 0.32 missed school days per week, and parents reported zero missed work days. Surveyed parents rated their child’s pain a 3.0.
Program staff include pediatric physical medicine and rehabilitation specialists, psychiatrists, hospitalists, nurses, psychologists and counselors, a social worker, physical therapists, occupational therapists, recreation therapists and a teacher.
- Kristen Buchannan, LISW
Child and Adolescent Psychiatry
- A. David Rothner, MD
- Marge Zabukovec, RN
- Debra Fath, BSN, RN
- Amber Johnson, BSN, RN
- Kathy Maier, BSN, RN
- Ashley O’Neal, BSN, RN
- Merideth Miller, RD, LD
- Ryan Suder, MS, OTR/L
Patient Care Management
- Dorothy Kasper, RN, BSN, CCM, CPN
- Hilary Coughlin, PT
- Heidi Kempert , PTA
- Rachel Pearson, PT, DPT
- Gayle Kanary, CTRS
- Oleh Zhakunets, BA
- Kristen Buchannan, LISW
You shouldn’t feel helpless. Your child is not alone, and neither are you. Explore our site further to learn more about specific pain conditions that can be effectively treated through our program, hear from patients who have found relief, and find additional resources that will guide you through the appointment process.
For more information or to refer a patient, call 216.448.6035.
Pediatric Pain Rehabilitation Assessment Clinic
The Cleveland Clinic Pediatric Pain Rehabilitation Assessment Clinic provides interdisciplinary evaluation of children and adolescents with chronic pain and related functional impairment (e.g., missed school days, withdrawal from friends and activities). Our evaluation is designed to help you determine which treatment services will be most effective in helping your child return to normal activity. It is one half-day in length and includes assessments by a physiatrist (a physician who specializes in rehabilitation medicine), a psychologist, and either a physical therapist or occupational therapist. You and your child will receive a tour of our facilities and have opportunities to learn more about the services we provide. At the conclusion, our interdisciplinary team will meet with your family to share our impressions and recommendations. This assessment is particularly helpful for patients and families considering our combined inpatient/day hospital interdisciplinary pain rehabilitation program. It allows our team to evaluate your child’s needs and gives you an opportunity to meet and observe us in action so that you can decide if we are the right fit for your child and family.
To schedule an evaluation in the Pediatric Pain Rehabilitation Assessment Clinic, please contact Terri Holmes at 216.448.6253.
The following resources will help you better understand our program, and what next steps you and your child can take toward finding relief.
Pediatric Pain Rehabilitation Program Sample Schedules
- Behavioral Treatment for Headache
- Patient & Visitor Information
- Webchat Transcript: How to Manage Chronic Pain in Children and Adolescents
- Webchat Transcript: Kids, Headaches and School Attendance
- Webchat Transcript: Understanding Kids' Headache
We have provided the following resources to help guide you in learning more about pediatric chronic pain, in general, and/or specific pediatric pain conditions.
- American Pain Society (APS)
- Pediatric Pain – Science Helping Children
- National Pain Foundation (NPF)
- International Foundation for Functional Gastrointestinal Disorders (IFFGD)
- National Fibromyalgia Association (NFA)
- National Headache Foundation (NHF)
- National Reflex Sympathetic Dystrophy Syndrome Association