Guidelines on the management of chronic pain in children
Ano de publicação: 2020
Chronic pain in children is a significant public health problem globally and a leading
cause of morbidity in children, with a negative impact on their emotional, physical
and social development and function. The lives of families and caregivers are also
significantly impacted. Chronic pain, defined as pain that persists or recurs for longer
than three months, can be primary (independent of any identified biological or
psychological contributing factor) or secondary to a clear, underlying etiology. Pain in
children differs from that in adults for a number of physiological, developmental and
social reasons, and thus data and research on, and clinical experiences with, adults may
not be directly applicable to children.
The management of chronic pain in children is complex and challenging, and there is a
paucity of high-quality research studies on treatment interventions and management
approaches. Pain management requires an approach that is tailored to each individual
and context, and is multimodal and interdisciplinary, requiring trained healthcare
providers and a coordinated, comprehensive, integrated response.
In these guidelines, the World Health Organization (WHO) provides evidence-informed
recommendations for the management of chronic pain in children. The recommendations
are based on the most current, high-quality scientific evidence, and were formulated
following processes and using methods that meet the highest international standards
for guideline development. The recommendations in this guideline are based on
systematic reviews of the evidence on benefits, harms, acceptability and feasibility, as
well as on equity and resource considerations. The recommendations were formulated
by the Guideline Development Group, consisting of individuals with diverse expertise
and experiences and with global representation.
The purpose of this guideline is to assist WHO Member States and their partners in
developing and implementing national and local policies, regulations, pain management
protocols and best practices. It will help countries balance concerns about ensuring
access to appropriate therapies for pain relief with the harms arising from misuse of
medications and other potential adverse effects of interventions for pain management.
These guidelines focus on physical, psychological and pharmacological interventions
for the management of primary and secondary chronic pain in children 0 to 19 years
of age.