Approaches to Pediatric Musculoskeletal Pain: Opioids and So Much More.

Treatment of musculoskeletal pain in children poses unique challenges, particularly in the context of the ongoing opioid epidemic. In addition to the developmental level of the child, the type of pain he or she is experiencing should influence the team's approach when collaborating with the patient and the family to develop and refine pain management strategies. Understanding the categories of pain that may result from specific types of musculoskeletal injuries or orthopaedic surgeries influences the selection of medication or other most appropriate treatment. Although opioids are an important part of managing acute pain in the pediatric population, many other pharmacological and nonpharmacological therapies can be used in combination with or in place of opioids to optimize pain management. This article will review strategies for collaborating with families and the multidisciplinary team, provide an overview of pediatric pain assessment including assessment of acute musculoskeletal pain in children, and discuss pharmacological and nonpharmacological options for managing pain after acute injury or surgery.