First of its kind pediatric rehab center offers hope to chronic pain sufferers
May 30, 2008
This June, the Mayo Family Pediatric Pain Rehabilitation Center (PPRC) will be opening at Children's Hospital Boston at Waltham. The PPRC will be the most comprehensive stand-alone, day hospital program of its kind in the United States to treat children and adolescents with Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD). RSD is a chronic neurological syndrome that affects skin, muscles, joints and bones, and causes severe burning, aching pain, color changes and temperature changes, and excessive sweating and swelling of extremities. The syndrome is more prevalent in patients who play sports and affects girls eight times more frequently than boys.
Often times misdiagnosed, patients with RSD have typically seen three to four specialists before they end up at the Chronic Pain Management Clinic at Children's, a multidisciplinary program which provides treatment and support for acute and chronic pain problems in children and young adults.
Charles Berde, MD, PhD"Many children and adolescents afflicted with RSD improve with standard outpatient care, but a slight percentage may require intensive daily treatment to get well," said Charles Berde, MD, PhD, Chief of Pain Medicine at Children's Hospital, and Executive Director of the PPRC. "This new center will provide an intensive daily program that has proven successful in relief of debilitating extreme pain. With the treatment received at PPRC, patients can expect to resume normal function and will regain the physical strength and endurance necessary to enjoy life again."
Berde, together with Navil Sethna, MB, ChB, and Bruce Masek, PhD, started the Chronic Pain Management Clinic at Children's in 1986 and have treated more than 750 children suffering from RSD--both inpatient and outpatient. Today, with the increased number of patients experiencing chronic pain, specifically RSD, the need for a specialized clinic became highly evident and Dr. Berde, along with his colleagues, has worked tirelessly to provide patients with the expert care required to ease their pain.
The treatment for RSD is intensive. Patients who do not improve with standard outpatient care are sometimes admitted to the hospital for more intensive treatment. The innovative program at Waltham is designed to provide a similar level of intensive treatment, but by using a day-hospital model, it is expected to save thousands of dollars in overnight stays. Upon evaluation via telephone and onsite at the outpatient clinic, and after exhausting other treatment options, eligible RSD patients from around the country are expected to benefit from the comprehensive day program.
The 2,500-square-foot PPRC is located on the ground floor of the Waltham campus and includes two bio-behavioral therapy rooms, two private physical therapy rooms, a physician consult room, a functional training area and a therapeutic pool with shower and changing area. In addition to those treatment-focused areas, the PPRC is also equipped with a conference room, an activity room for participants, two handicap accessible bathrooms and an administrative front office.
The PPRC team is made up of a number of talented physicians, psychologists, physical therapists, occupational therapists and nurses--all critical to the care of PPRC patients. Child life specialists and social workers are available on a consultative basis.
RSD usually develops in an injured limb, such as a broken leg. However, many cases of RSD involve only a minor injury, such as a sprain, and in some cases, no precipitating event can be identified. Tell-tale symptoms of RSD include continuing pain, extreme sensitivity to touch, evidence of swelling, changes in skin blood flow (skin color changes, skin temperature changes) or abnormal sweating in the region of the pain.
Many modalities may be used for treatment, including medication, physical movement therapies, and cognitive behavioral therapies. Additionally, physical movement and weight-bearing are critical factors in RSD rehab, not only to keep limbs from atrophy, but also because it is thought that exercise helps to quiet the small nerve fibers on a molecular level. Exercise also has profound effects on the central nervous system and specifically on reversing some of the effects of chronic pain on patterning of activity in the brain and spinal cord.
Beginning in June, the Mayo Family Pediatric Pain Rehabilitation Center will be open Monday through Friday, 8am to 4:30pm. For additional information and details on how to enroll in the program, please click here.
Children's Hospital Boston is one of the nation's premier pediatric medical centers. Founded in 1869 as a 20-bed hospital for children, today it is a 397-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's is the primary pediatric teaching affiliate of Harvard Medical School, the largest provider of health care to the children of Massachusetts, and home to the world's leading pediatric research enterprise. For more information about Children's, visit: www.childrenshospital.org/newsroom.