Jennie C I Tsao Marcia Meldrum and Lonnie K Zeltzer Summary

Pain may be a major cause of physical and emotional distress in chronic pediatric conditions, including cancer, juvenile arthritis, and cystic fibrosis. Complementary and alternative medical (CAM) therapies have become important and frequently used modalities in treating children's pain. Yet, many practitioners have questioned whether there is sufficient evidence to support the efficacy and safety of CAM approaches for pain relief. This chapter aims to address these concerns by presenting a critical review of the available published evidence. We evaluated published studies testing CAM interventions for chronic or acute procedural pain; these study methodologies employed either controlled trials or multiple baseline studies. The evaluation criteria were developed by the American Psychological Association Division 12 Task Force on Promotion and Dissemination of Psychological Procedures to assess nonpharmacological therapies. Few of the CAM modalities qualify as empirically supported therapies under these rigorous criteria, although several met the standard for possibly efficacious or promising for pediatric pain. Our review of the published literature revealed a number of methodological flaws in existing studies. Clearly, more research on CAM therapies for children's pain is needed.

Key Words: Alternative medicine; children; complementary medicine; pain; pediatric pain.

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