We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Communication |

Current Status of Pain Management in Children

Richard F. Howard, MB, FRCA
JAMA. 2003;290(18):2464-2469. doi:10.1001/jama.290.18.2464.
Text Size: A A A
Published online

Many changes have taken place in pediatric pain management since the undertreatment of children's pain was first reported. Notable advances include an increase in understanding pain during development and improvements in the management of acute pain. Although much more about the safe and effective management of pain in children is now known, this knowledge has not been widely or effectively translated into routine clinical practice. Lack of suitable research on which to firmly establish evidence-based care is likely to have contributed to this situation. A subject of considerable interest recently is the discovery that the experience of pain in early life may lead to long-term consequences. New research findings from laboratory and clinical studies have clearly identified possible mechanisms and provided evidence that long-term behavioral changes can extend far beyond what would be considered the normal period of postinjury recovery. Timing, degree of injury, and administered analgesia and its nature may be important determinants of the long-term outcome of infant pain. Chronic pain, including neuropathic pain, is far more common in children than was thought. The assessment and treatment of this pain and its functional consequences present a considerable unmet challenge. There is a pressing need for further research and clinical development in the management of pain in children.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

113 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience
Pain and Opioid-Induced Neurotoxicity Contributing to Fatigue

Care at the Close of Life: Evidence and Experience
Treatment of Pain and Opioid-Induced Neurotoxicity