ABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: In spite of its importance, neuropathic pain is underestimated and undertreated in childhood. Although many conditions causing neuropathic pain in adults are uncommon during childhood, most therapeutic strategies effective for adults were extrapolated for the pediatric population. This study aimed at bringing to light peculiarities of neuropathic pain in children, which shall contribute for its better recognition in childhood and adolescence. CONTENTS: Pubmed, Scielo and Lilacs databases were queried to identify studies and literature reviews on neuropathic pain during childhood and adolescence. CONCLUSION: Neuropathic pain treatment in childhood and adolescence should be multimodal, including pharmacological treatment, rehabilitation and psychological support. Rehabilitation, physiotherapy, occupational therapy and integrative therapies should be part of the integral treatment in childhood and adolescence and vary in a case-by-case basis.
RESUMO JUSTIFICATIVA E OBJETIVOS: Apesar de sua importância a dor neuropática é subestimada e subtratada na infância. Embora muitas das condições que causem dor neuropática no adulto sejam raras na infância; grande parte das estratégias terapêuticas que demonstraram ser eficazes em adultos foi extrapolada para uso na população pediátrica. O objetivo deste artigo foi trazer à luz peculiaridades da dor neuropática na criança, o que contribuirá para seu melhor reconhecimento na infância e adolescência. CONTEÚDO: Foram realizadas buscas nos bancos de dados Pubmed, Scielo e Lilacs, identificando-se estudos e revisões da literatura sobre dor neuropática na infância e adolescência. CONCLUSÃO: O tratamento da dor neuropática na infância e adolescência deve ser multimodal, incluindo tratamento farmacológico, reabilitação e suporte psicológico. Reabilitação, fisioterapia, terapia ocupacional e terapias integrativas devem fazer parte do tratamento integral na infância e adolescência, e variam conforme as necessidades em cada caso.
ABSTRACT
El dolor crónico es un síndrome presente en muchas enfermedades crónicas, se acompaña de fenómenos desensibilización central y frecuentemente de síntomas de angustia, depresión, alteraciones del sueño, fatiga, fallasen la concentración y atención, y en disminución de las actividades de la vida diaria. El tratamiento del dolor crónicodebiese ser multimodal, en donde la psicoterapia tiene un papel importante. La terapia cognitivo-conductual ha demostrado ser eficaz en el manejo del dolor, pero su efecto es limitado y no considera el trabajo en el foco corporal ni relacional sistémico familiar. El enfoque psicoterapéutico integrativo-multidimensional aborda elementos cognitivos, conductuales, relacionales, dinámicos y sistémicos en un contexto individual, familiar y social, permitiendo una visión holística del problema del paciente. Las intervenciones mente-cuerpo trabajan en el cambio de la vivencia corporal en el aquí y ahora, y entregan herramientas de autogestiónpara que el paciente desarrolle. Al unir ambos enfoques integrativo multidimensional e intervenciones mente-cuerpo, el tratamiento y manejo del dolor se hace más eficaz. El objetivo del presente trabajo es proponer, desde un punto de vista cualitativo, un modelo de enfoque psicoterapéutico integrativo multidimensional e intervención mente-cuerpo en el manejo de los pacientes con dolor crónico.
Chronic pain syndrome is present in many chronic diseases, in which the pain is accompanied by central sensitization phenomena and often symptoms of anxiety, depression, sleep disturbances, fatigue, lapses in concentration and attention and reduced activity daily life. The treatment of chronic pain ought to be multimodal, where psychotherapy has an important role. Cognitive-behavioral therapy has proven effective in pain management, but its effect is limited and does not consider the work at home body or systemic relational focus. The multidimensional-integrative psychotherapy approach addresses cognitive, behavioral, relational, dynamic and systemic elements in an individual, family and social context, allowing a holistic view of the patients problem. The mind-body interventions work in change of body experience in the here and now provides tools for self-management for the patient develops. By joining both multidimensional integrative and interventions body-mind pain management it becomes more effective. The aim of this study is to propose a qualitatively multidimensional model of integrative psychotherapy approach and intervention mind and body in the chronic pain management.