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.

osce communication and clinical station3 min readVerification in progress

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]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References8Show ledger

[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

Adolescent chronic pain and functional symptoms OSCE — validation, function-first plan and school reintegration

osce communication and clinical station3 min readVerification in progress

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]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References8Show ledger

[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