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Chronische muskuloskelettale Schmerzen bei Kindern und Jugendlichen

Chronic musculoskeletal pain in children and adolescents

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Zusammenfassung

Muskuloskelettale Schmerzen sind bei Kindern und Jugendlichen mit einer 3-Monats-Prävalenz von 71% bei Gesunden häufiger als bislang angenommen. Die Bandbreite von akuten zu chronisch-somatisch-bedingten bis zu chronisch-idiopathischen Schmerzsyndromen ist groß, und Differenzialdiagnostik und Therapie erfordern häufig interdisziplinäre Zusammenarbeit. Mit zunehmender Chronifizierung werden die Symptome immer stärker psychosozial überlagert und modifiziert. Inaktivität und eine depressive Grundstimmung stigmatisieren chronische Schmerzpatienten häufig. Dies ist für die Planung einer erfolgreichen Therapie relevant. Akut-inflammatorische Schmerzen, wie bei der juvenilen idiopathischen Arthritis, sollten durch eine effektive Therapie mit Medikamenten und Physiotherapie behandelt werden. Chronisch-idiopathische Schmerzsyndrome wie das juvenile primäre Fibromyalgiesyndrom und das komplexe regionale Schmerzsyndrom lassen sich medikamentös nur unzureichend therapieren. Hier sind multimodale Therapieansätze unter Einbeziehung von Psycho-, Sport- und Kunsttherapie sehr erfolgreich.

Abstract

Musculoskeletal pain (MSP) has been found to have a 3-month prevalence of 71% even in healthy children and adolescents. A broad variety of MSP exists, including acute inflammatory, chronic somatic, and chronic idiopathic pain syndromes. An interdisciplinary workup is mandatory in the diagnostic workup and treatment. Psychosocial interactions, immobility, and a depressive temper are dominating in patients with chronic MSP; this has been shown to be relevant to treatment. Acute inflammatory MSP in juvenile idiopathic arthritis should be treated with an effective medication plus physiotherapy. In chronic idiopathic pain syndromes such as juvenile primary fibromyalgia and complex regional pain syndrome, analgetic drugs usually fail; however, multimodal strategies, including psychotherapy, sports therapy, and art therapy, have been shown to be effective.

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  1. Deutsches Zentrum für Kinder- und Jugendrheumatologie, Gehfeldstraße 24, 82467, Garmisch-Partenkirchen, Deutschland

    J.P. Haas

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Haas, J. Chronische muskuloskelettale Schmerzen bei Kindern und Jugendlichen. Monatsschr Kinderheilkd 157, 647–654 (2009). https://doi.org/10.1007/s00112-009-1959-0

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