Paeds Cases · adolescent-and-young-adult-medicine
Adolescent chronic pain and functional symptoms OSCE — validation, function-first plan and school reintegration
Observed structured encounter testing a validating, function-first adolescent chronic-pain consultation: biopsychosocial assessment, red-flag screening once, central-sensitisation reframing, an interdisciplinary plan with school reintegration, and avoidance of opioid escalation.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 15-year-old with four months of widespread pain, broken sleep and school absence; the family wants more tests. Station B is a 14-year-old with complex regional pain syndrome of the leg who has stopped attending school and whose mother requests stronger painkillers.
Station objectives
- Validate chronic pain as real and screen once for red flags, without over-investigating. [1] [8]
- Explain central sensitisation in validating, understandable language. [2]
- Co-build a function-first interdisciplinary plan with explicit functional goals. [3]
- Treat school reintegration as a clinical outcome and address family factors without blame. [4] [5]
References8ShowHide
- [1]Simons LE; Basch MC State of the art in biobehavioral approaches to the management of chronic pain in childhood. Pain management, 2016.PMID 26678858
- [2]Woolf CJ Central sensitization: implications for the diagnosis and treatment of pain. Pain, 2011.PMID 20961685
- [3]Fisher E; Law E; Dudeney J Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane database of systematic reviews, 2018.PMID 30270423
- [4]Logan DE; Simons LE; Stein MJ School impairment in adolescents with chronic pain. The journal of pain : official journal of the American Pain Society, 2008.PMID 18255341
- [5]Logan DE; Simons LE; Carpino EA Too sick for school? Parent influences on school functioning among children with chronic pain. Pain, 2012.PMID 22169177
- [6]Kashikar-Zuck S; Ting TV; Arnold LM Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial. Arthritis and rheumatism, 2012.PMID 22108765
- [7]Sherry DD; Sonagra M; Gmuca S The spectrum of pediatric amplified musculoskeletal pain syndrome. Pediatric rheumatology online journal, 2020.PMID 33046102
- [8]King S; Chambers CT; Huguet A The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 2011.PMID 22078064