Pain Management (Pediatric Chronic Pain Management)

The Chronic Pain Management Clinic at The Montreal Children’s Hospital helps patients and families dealing with physical, psychological, spiritual and social factors associated with complex medical conditions. 

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Our history

The Montreal Children’s Hospital Chronic Pain Management Clinic was launched in 1993 as a multidisciplinary service for children with chronic pain conditions. The initial goal of the clinic was to pay particular attention to the specific challenges associated with pain conditions.

In 1997, the clinic adapted its model, which it still follows, to allow specialists to come together and simultaneously interview patients and families. Patients who are seen at the clinic meet with all members of the team, so that everyone can keep track of the discussion about treatments being offered and can analyze the outcome together.

Over the years, the number of referrals to the Clinic has grown to about 120 new patients per year with around 400 visits annually. The clinic’s waiting time is no more than three months. In between clinic visits, patients undergo interventions in psychology and physiotherapy; additionally, a social worker and a clinical nurse specialist provide support to parents.

Our team

Five specialists make up the core group of the Pain Management team, and include a pediatric anesthesiologist, a psychologist, a physiotherapist, a social worker, and a nurse clinician. All five professionals have extended experience in helping patients and families with chronic pain conditions. The team also includes consultants from other medical specialties such as Surgery, Psychiatry, Gastroenterology, Rheumatology, Urology Neurology, and Radiology.

Department head:

  • Dr. Pablo Ingelmo, Department of Anesthesia, Director - Chronic Pain Management

 

Staff members :

 

Clinical Staff

  • Dr. Yves Beaulieu, Psychologist 
  • Rachel Gauvin, Physiotherapist 
  • Stephanie Stabile, Social Worker
  • Rebecca Pitt, Nurse Clinician 

 

Clinical Fellows

  • Gonzalo Rivera (2014-2016)
  • Eduardo Vega Perez (2016-2017)
  • Victor Hugo Gonzalez Cardenas (2017-2018)
  • Marta Somaini (2018-2019)  

 

Psychology Residents

  • Vanessa Iacono (2017-2018)
  • Chelsea de Estrela (2017-2018)

 

Research and Education

  • Dr. Nada Mohammed, Clinical Research Coordinator
  • Anna Radzioch Guérin, Educational Project Coordinator
  • Christina Rosmus, Educational Consultant

Administration

  • Cindy Grenier, CPS Administration
  • Rita Barrafato, Administrative Technician
  • Pina Diana, Manager of Respiratory and Anesthesia Services

 

Where the care happens

Chronic pain patients are seen in our clinic room in the south clinic, which provides a calm environment for the patient, family, and the team, as well as space for a wheelchair if need be. After the initial visit with the team, the patient will be individually followed as needed by each member of the team in their own settings. For psychotherapy, this would be in the gym; for psychology, it would be in individual therapy session rooms; for social work, this would be in a family room and/or by telephone.

Our services
  • Physiotherapy Interventions

This type of treatment is centered on returning a patient to normal functioning through reconditioning, the use of laser and ultrasound treatments, or through adapted exercises such as stretching, strengthening, and endurance.

  • Psychology Interventions

This type of treatment focuses on relaxation, the development of coping strategies, cognitive behavioural adjustments and techniques such as biofeedback (a treatment technique in which patients are trained to improve their health by using signals from their own bodies).

  • Medical Interventions

These types of treatments can involve medications or diagnostic and therapeutic regional blocks (medicating a specific part of the body) to control pain. Communication and detailed explanations between patients and members of the team are essential in the success of these types of treatment plans.

  • QST Evaluation Program

Quantitative Sensory Testing (QST) is a clinical methodology that identifies alterations in the facilitatory pain processes (i.e peripheral and central sensitization). As part of QST, the conditioned pain modulation (CPM) paradigm is used to assess the efficacy of the endogenous pain inhibitory pathways. The extent of pain inhibition during conditioning reflects the efficacy of the diffuse noxious inhibitory control (DNIC) system. The assessment of underlying pain mechanisms with QST and CPM as part of a standard clinical evaluation facilitates decisions concerning pharmacological treatment towards a mechanism-based personalized pain treatment. 

  • Nursing Interventions

The nurse is the communication hub of the team by providing support to families and facilitating coordination between the team and patients. The nurse links children and families with other members of the team based on evolving issues, continuously oversees responses to, and side effects of, treatment, collaborates with families and team members to update plans and goals, and builds connections with healthcare workers at primary health centers

  • Social Work

The social worker bridges the gap between the hospital and the school. The social worker (along with other members of the team) can provide the necessary education and tools to schools to allow a child who is suffering from chronic pain to attend school regularly. The influence of the social workers in the efficacy of the treatment includes their therapeutic efforts with the parents. 

Refer a patient 

Room number: A 02.2227, Glen site
To make an appointment or reach the office call: 514-412-4448
Fax: 514- 412-4341

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