(Kiosk 6) Intensive Interdisciplinary Pain Treatment for Pediatric Patients with Post-covid Amplified Musculoskeletal Pain Syndrome

Case Diagnosis: Three pediatric patients with post-COVID amplified musculoskeletal pain syndrome demonstrated benefit after an intensive interdisciplinary pain treatment program.

Case Description or Program Description: Post-COVID syndrome is common in adults but emerging literature demonstrates it is a significant problem for children and adolescents as well, with the most frequently reported symptoms being fatigue, headaches and chronic pain. These symptoms can have a significant impact on children's physical, social and emotional wellbeing, resulting in absence from school, sports and social activities, as well as a decline in functional independence and ability to perform ADLs. We present three school-aged children who developed post-COVID chronic pain and were diagnosed with amplified musculoskeletal pain syndrome (AMPS), all with significant functional limitations and school absence, who participated in an intensive interdisciplinary pain treatment program (IIPT). IIPT is a program for patients with amplified chronic pain who continue to have significant deficits in function despite consistent and current outpatient therapies and involves an interdisciplinary approach to focus on regaining function, de-emphasizing pain and developing appropriate pain management skills. The program includes comprehensive PT, OT, aquatherapy, nutrition, yoga, meditation, psychological counseling, education and recreational therapy. Multiple scoring systems are utilized to track progress through the program, including Bruininks-Oseretsky Test (BOT-2), Pediatric Quality of Life Inventory (PedsQL), Numeric Rating Scale (NRS), the 6-Minute Walk Test and the Functional Disability Inventory (FDI). The typical length of stay is two to four weeks.

Setting: Pediatric inpatient rehabilitation hospital

Assessment/Results: All three patients had improved pain and function after participating in IIPT. Specifically they had improved NRS, BOT-2 scores, 6-minute walk tests, and PedsQL upon discharge from the program. The FDI was utilized with one patient, who demonstrated an improved score upon discharge. They also had better school attendance after follow up.

Discussion (relevance): Post-COVID chronic pain is a significant burden for patients and their families. Finding a rehabilitation strategy that improves function and return to daily life is integral to improve outcomes.

Conclusions: IIPT may be an effective treatment for children experiencing post-COVID AMPS and warrants further study.