The World Health Organization (WHO), the global agency responsible for public health, has adopted new guidelines into the diagnosis, treatment and management of chronic pain in children, informed directly as a result of research evidence from the University of Bath.
Based on the latest, high-quality, scientific evidence, the purpose of the new guidelines is to help WHO member states and partners around the world in implementing national and local policies, pain management protocols and best practice. This builds on nearly two decades of research from the Centre for Pain Research at Bath, including, most recently, the benchmark Lancet Child & Adolescent Health Commission, which was authored by Dr Emma Fisher and Professor Christopher Eccleston.
That report suggested that much more needed to be done to support young people experiencing chronic pain, calling for four clear goals: to make pain matter, to make it understood, to make it (more) visible and to make it better. Up to 10% of young people experience disabling chronic pain into early adulthood, with conditions including arthritis, other types of musculoskeletal pain, recurrent abdominal pain, and headaches. Yet how paediatric pain is recognised, assessed and treated has long varied and often gone under the radar.
Drawing on the Lancet Commission work and seminal research from the Centre for Pain Research, the new WHO guidelines recommend that when treating young people with pain, it is vital to treat them using a biological, psychological, and social approach, including pharmacological, physical and psychological treatments. This is the first time that the WHO has recommended this approach for children and adolescents with chronic pain.
Professor Eccleston, Director of the Centre for Pain Research, explained: “It is no exaggeration to say that these new WHO guidelines, the first of their kind, will be revolutionary when it comes to how young people around the world struggling with chronic pain are diagnosed and treated. This will have far-reaching global impact.
“This is quite a remarkable shift after over two decades of working on these issues. From a starting point in the early 2000s where how childhood pain was understood and treated was severely limited, to today, where we see new global guidelines all informed by evidence from Bath, it’s particularly rewarding for all of us at the Centre for Pain Research to see how our research is being applied.”
Dr Emily Harrop, Co-Chair of the Guideline Development Group and Consultant in Paediatric Palliative Care (Oxford) explained: “A consistent, internationally-agreed approach to the management of chronic pain will have an enormously positive impact on what is one of the leading causes of morbidity in childhood. By advocating a comprehensive biopsychosocial approach to the treatment of pain, and highlighting the importance of the principles of opioid stewardship, these new WHO guidelines will contribute to an improved quality of life for children globally.”
Professor of Pediatrics at the University of California at San Francisco and President of the International Association for the Study of Pain (IASP), Stefan Friedrichsdorf added: "The importance of the new 2020 WHO Guidelines on the management of chronic pain in children cannot be understated for our field of pediatric pain research, advocacy, and clinical care. I am extremely pleased we all now have this significant contribution available worldwide, and I would like to especially thank the contributors for their excellent work."
Pro-Vice-Chancellor (Research) Professor Jonathan Knight added: “This news is a tremendous accolade and endorsement for the work of Dr Fisher, Professor Ecceleston and all colleagues at the Centre for Pain Research. It reflects the dedication and commitment they have all shown to breaking down the multiple, complex challenges which surround paediatric pain in order to propose better diagnosis and treatments. Having now been adopted by the World Health Organization through these new guidelines, it demonstrates just how world-leading research from Bath can truly have a worldwide impact.”