Pediatric pain management and chronic pain care

At OHSU Doernbecher Children’s Hospital, we can help your child feel less pain so they can eat, sleep, play and heal.

Uncontrolled pain can disrupt daily life, delay healing and affect vital functions like blood pressure and heart rate. We can help your child return to normal activities with a safe, personalized care plan.

You’ll find:

• We offer the widest range of pediatric pain treatment options in Oregon.
• We partner with pain management experts across the country when needed.
• We measure success by your child’s ability to go to school, sleep well, socialize and be active.

Learn more about:

• How to become a patient
• Types of pain we treat
• Understanding your child’s pain
• Treatment options
• Helping your child cope with pain

What your family can expect

Our multidisciplinary team includes pediatric doctors, nurses, psychologists, anesthesiologists, and physical therapists — all with expertise in pain care for infants, children, and teens.

• Personalized care plans tailored to your child’s unique needs
• Support both in the hospital and at home
• Partnership with your child’s primary care provider and other specialists

How to become a patient

Your child needs a referral from their primary care provider, or the provider who manages the condition causing their pain. It usually takes 4-6 weeks to process your referral. If you haven’t heard from us in four weeks, call 503-494-7246.

Your first visit

Your child’s first visit is a complete evaluation with our full team. It includes:

• Detailed review of medical history
• Physical exam
• Psychological evaluation
• Input from your family about how pain is affecting your child
• A customized treatment plan that begins that same day

Types of children’s pain we treat

We focus on treating symptoms, not diagnosing health issues. Your child’s primary care or specialist provider will diagnose any conditions before referring you to us.

Pain in the hospital

We help manage pain day and night for children in the hospital due to:

• Injuries
• Surgery
• Illness or treatment for serious conditions, like cancer
• Weaning from long-term use of sedatives or pain medications

Chronic or recurring pain at home

We also treat long-term or recurring pain conditions, including:

• Headaches and migraines
• Back pain
• Muscle and connective tissue (myofascial) pain
• Fibromyalgia
• Abdominal pain
• Post-surgical pain
• Pain from nerve damage (neuropathic pain)
• Complex regional pain syndrome (or reflex sympathetic dystrophy)
• Amplified musculoskeletal pain syndrome
• Pain related to chronic illnesses like arthritis or cancer

Understanding your child’s pain

Pain can affect your child’s mood, energy, and daily life. Every child experiences and expresses pain differently. Understanding your child’s pain is the first step toward effective treatment.

How we measure pain

• Infants and non-speaking children: We observe behavior, facial expressions, movement, and vital signs.
• Children ages 3–7: We use a face scale to help them describe pain intensity.
• Children 7 and older: We use a 0–10 pain scale, with 0 being no pain and 10 being the worst imaginable.

You can use these methods at home too and share the results at your child’s appointments.

How we treat pain

We create a personalized treatment plan that supports your child’s whole health. Treatment may include both medication and non-medication strategies.

For chronic pain, we prioritize non-drug approaches. During hospitalization or after surgery, medications may be best, but we use them with caution.

Common treatments include:

• Safe use of pain medications
• Nerve blocks or injections
• Physical therapy and movement-based therapies
• Cognitive and behavioral treatments with a psychologist who has expertise in pain
• Complementary therapies like acupuncture, massage or guided imagery
• Support to stay involved in school and other activities

Safe use of pain medications

We avoid medication when possible, but it is sometimes necessary. We always balance your child’s safety with their comfort in our treatment recommendations.

Our approach to opioids and other strong medications is:

• Use only when necessary, such as after surgery or serious injury
• Prescribe short-term and monitor closely
• Rarely use for chronic pain
• Use a pain medicine agreement to help prevent misuse

Resources for families

Comfort Ability Workshop: This OHSU workshop is for youth age 10-17 and their parents. It can help your child better manage their pain and practice coping skills.