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KCUR: To Treat Pain Syndrome, Children's Mercy Doctors Try To Change How 'Brain Interprets Signals'

By Anne Kniggendorf

The pain might start after bumping an elbow on a kitchen counter. Or maybe the incident was more minor than that, and went completely unnoticed. But for some people, what begins as "nothing" converts to searing pain over part or all of the body.

"If you sprain your ankle, the nerves should turn off after a while once that's healed, that pain signaling should die down. But if you have a chronic pain syndrome, the nerves don't get the memo to turn off," says Cara Hoffart, a rheumatologist at Children's Mercy Hospital.

The result is something clinicians often refer to as Amplified Pain Syndrome, though it's sometimes called juvenile fibromyalgia or central sensitization syndrome.

Hoffart is part of the team in the Rehabilitation for Amplified Pain Syndrome Program at Children's Mercy. It offers intensive physical and occupational therapy, relaxation techniques, stress-management training, and music and therapeutic art in three to four-weeks sessions.

Patients in the Children’s Mercy program are in varying degrees of distress. Hoffart says some have extreme pain in their limbs and experience nausea and vomiting.

If someone has a sprained ankle, walking is painful. For the person with Amplified Pain Syndrome, putting weight on an ankle, for example, might still hurt, though the bones and tissues are in good shape. Should the person with no apparent injury continue to walk?

Hoffart and members of the Children's Mercy team say yes. They have learned that the nerves and brain must receive the message that nothing bad happens if the person walks on the ankle anyway.

This type of medicine is attractive to Hoffart, because she can help some very disabled patients regain normal functioning without unusually potent medications or invasive procedures.

She says she understands people's concerns when they hear about a treatment plan that involves asking patients to do hard things.

"What you don’t necessarily hear is the amount of empathy that our team has," she says, "and the way that we really connect to our patients and their families in a way that I think other medical professionals in other specialties don’t get to do."


Read the full story via KCUR

Learn more about the RAPS Program at Children's Mercy