Pain and Palliative Care Clinic

The Pain and Palliative Care Clinic provides care for children with acute pain, chronic pain and life-threatening illnesses. Pain is a complex and unique experience that affects all areas of a child or adolescent’s life. Whether the pain is caused by a chronic illness or has an unknown cause, it can impact relationships, school, mood, sleep, family life and everyday responsibilities.

Our Pain and Palliative Care Clinic brings together a multi-specialty team of doctors, anesthesiologists, nurse practitioners, psychologists and social workers to meet the special needs of each child facing pain issues or a chronic illness.

  • Acute Pain Care

The MAGIK (Making Aches Go Away in Kids) Pain Service cares for more than 1,800 patients each year, including oncology patients and provides in-hospital 24-hour pain management coverage, seven days per week.

The service works to prevent avoidable pain and minimize or alleviate discomfort in a safe environment. In addition to pain assessments, the team offers medication management, coordination of other therapies and integration with other specialties to achieve a comprehensive treatment plan.

Making Aches Go Away In Kids (MAGIK)

The MAGIK acute pain service cares for hospitalized children with pain associated with:

  • Surgery
  • Trauma or injury
  • Acute exacerbation of chronic pain
  • Specific illness or disease
  • Headaches
  • Acute abdominal pain
  • Limited mobility
  • Complications of treatments

How We Alleviate Pain

We can provide pain control using a variety of techniques, which include:

  • Intravenous opioids using Patient Controlled Analgesia (PCA) pumps
  • Regional Therapies: Epidurals, Spinals, Peripheral Nerve Blocks
  • Animal Assisted Therapy
  • Topical therapies to minimize pain

Psychological and Psychiatric Support

We offer psychological and psychiatric support for children and their families to help cope with the stressors of living with acute pain and guide them with techniques to help improve daily functioning.  Additional support and care is provided through outpatient follow-up in the Pain Clinic.

  • Chronic Pain Care

The Pediatric Pain Management Clinic follows nearly 350 patients a year, providing assistance with complex and/or long-term pain issues. Along with assessment and management services, it offers individual and family therapy; breathing, relaxation and imagery training; counseling on parenting issues; education and coordination of care.

Why Choose Us?

Pain is a complex and unique experience that affects all areas of a child/adolescent’s life. Whether the pain is caused by a chronic illness or has an unknown cause, it can impact relationships, school, mood, sleep, family life and everyday responsibilities.

Children and adolescents who experience chronic pain and their families may see an increase of hopelessness, loss of dreams and goals, increased stress, and may have symptoms of depression and anxiety leading to physical and emotional difficulties. Without a comprehensive assessment and integrative health treatment focused on rehabilitation, the pain-stress cycle can continue.

Pain cannot always be eliminated, but often times can be reduced to tolerable levels, thereby enhancing function and quality of life. The Pediatric Pain Management Clinic has developed a program to meet the needs of infants, children, adolescents and their families who are experiencing pain and these associated problems.

Assessment

  • Pain Assessment
  • Psychological Evaluation
  • Behavioral Assessment

Conditions Commonly Treated

  • Abdominal Pain (Functional and Recurrent)
  • Cancer pain
  • Complex Regional Pain Syndrome (formally RSD)
  • Fibromyalgia
  • Headaches
  • Migraines
  • Musculoskeletal pain
  • Neuropathic pain
  • Rheumatologic conditions
  • Sickle cell disease

Typical Treatment Methods

Treatment methods that our team employs include:

  • Biofeedback training
  • Stress management
  • Cognitive behavioral interventions
  • Psychiatry
  • Acupuncture
  • Massage
  • Medication management

At the end of the evaluation, the team will make recommendations for follow-up with the same evaluating providers and with other pediatric subspecialty experts, as needed. These may include exercise medicine, rehabilitative medicine, and integrative medicine. If needed, the team is able to provide community referrals/resources.

  • Acupuncture Program
  • Research

The Acupuncture Program at Children's Hospital Los Angeles is one of the only centers solely dedicated to children in California and the west coast. Our child-friendly specialists understand the sensitivities that children face, especially when parents have exhausted other pain management resources.

Our staff helps to holistically manage symptoms and support the physical, emotional, psychological and functional well-being of the patient and family as a comprehensive treatment plan. Licensed pediatric acupuncturists are trained and successful in helping children feel relaxed. We provide developmentally appropriate education to children and their families about the role and mechanisms of acupuncture treatment.

Our acupuncturists are skilled at putting children at ease to decrease any anxiety or fear associated with the needles used for acupuncture. We have found that when a child is able to see and hold the acupuncture needle, while the staff demonstrates the hair-like thinness of the needle, children and their family's perceived stress and anxiety levels decrease significantly.

The Acupuncture Program sees patients ranging in age from 18 months to 22 years old.

How Acupuncture Works for Children

We use very thin needles that are flexible and the size of a strand of hair. Pediatric acupuncture requires much fewer needles than adults. Our acupuncturists are equipped with alternatives to using needles for young infants that may squirm or move around frequently:

  • Magnets
  • Acupressure
  • Tacks (a press needle that looks like a small Band-Aid)

Most children experience little to no pain and report less than 2 out of 10 pain associated with needles directly.

Conditions We Treat

  • ADHD
  • Allergies
  • Anxiety
  • Asthma
  • Arthritis
  • Bowel Syndrome
  • Cancer pain
  • Cystic Fibrosis
  • Fibromyalgia
  • Headaches
  • HIV
  • Migraines
  • Muscle pain
  • Neuropathic pain
  • Rheumatologic conditions
  • Sickle Cell Disease

Acupuncture Benefits and Results

The Acupuncture Program is highly regulated and specialized. The benefits of pediatric acupuncture have repeatedly demonstrated improved health outcomes and quality of life for patients. Our program prides itself in results. Patients who have rated their initial pain as a 6 or 7, out of ten, have frequently reduced their pain level to "0" within the session and reduced overall pain intensity to less than "2" over a series of treatment.

Treatment Plans and Education

The best results from acupuncture increase with a continued comprehensive treatment plan.

A minimum of two sessions per week may initially be required to get full relief.

Acupuncture historically was used as a preventative medicine practice and has now been applied as a treatment for disease and symptom management.  

Our program collaborates with Yo San University of Traditional Chinese Medicine, which supports ongoing education, training, supervision and mentorship in Masters and Doctoral level acupuncture trainees.

Our Division provides extensive educational and administrative assistance to the hospital. We are actively involved in the education of residents, fellows, nurses, psychologists, social workers and spiritual care providers.

We also provide input or oversight on the development, implementation and ongoing assessment of all pain educational programs at the hospital, in order to minimize any discomfort and distress patients and families may experience.

In addition, we offer a lecture series for the pediatric and anesthesiology house staff, and are creating a hospital-wide pain management education standard, ranging from routine blood draws to end-of-life care.

Currently, our research interests include:

  • Chronic pain
  • Complementary and alternative medicine therapies, including acupuncture, massage therapy and biofeedback
  • Health-related quality of life
  • Sleep