Interdisciplinary Pain Rehabilitation Programs for Adolescents with Chronic Daily Headache

Chronic daily headache affects 2.4% of adolescent girls and 0.8% of adolescent boys. Some of those affected experience a downward spiral of increasing functional disability over time. Those in the downward spiral do not attend school, interact with peers, and/or participate in sports and extracurricular activities. Despite advances in pharmacological and psychologically based treatments, unidisciplinary and symptom-focused strategies may not lead to an acceptable resolution of the condition. For patients who don’t respond well to traditional approaches, an interdisciplinary rehabilitation approach provides a useful and understandable model of care. In a recent study by Rothner et al. 24 adolescents experiencing this disability were treated in a 3 week, combined inpatient and day hospital pain rehabilitation program. At the beginning of the program on average the patients rated their pain as 7.29 out of 10 and missed an average of 2.14 days of school per week. After completing the program, follow-ups took place 1 and 2 years later with patients reporting 4.5/10 headaches with 0.71 missed days/week at the 1 year mark, and 2.25/10 headaches and 0.14 missed days at the 3 year mark. These results show that interdisciplinary pain rehabilitation is a promising approach to treating chronic daily headache and associated disability, which warrants further research. “It takes a village” to help an adolescent with pain. Those villagers may be physical therapists, psychotherapists, yoga instructors, biofeedback specialists, etc. etc..