Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232


(615) 936-1000

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Outpatient Pain Clinic

 

We see patients on Wednesdays. Call (615) 936-1840 for information about patient referral.

The Pediatric Outpatient Pain Clinic provides consultation to referring physicians regarding chronic pain management issues. Dr. Stephen Hays and Dr. Andrew Franklin, both board certified pediatric anesthesiologists with specialized training in pediatric pain management, consult at the clinic.

Our clinic does not to take over the management of your patient's pain needs. We instead function as a consultation service to evaluate and provide initial treatment options.

After establishing a stable regimen acceptable to the patient and the Pediatric Pain Clinic physicians, the expectation is that a primary care physician or referring physician will assume care. The process of reaching this regimen may take weeks or several months. If care is transferred back to the referring physician, our clinic is available to re-evaluate the patient if the clinical situation changes. Pain management strategies may include multiple specialists, including physical therapists or mental health specialists.

Common clinical symptoms prompting referral

Headache
Headache is a common pain complaint in children. We may evaluate the patient's medication regimen and adjust as appropriate. We also provide interventional techniques for pain refractory to medical management, such as occipital nerve blocks. Prior to referral, we require that the patient have an imaging study such as CT or MRI performed with results faxed to our clinic. We expect the referring provider will attempt basic headache management, with failure or insufficient management of pain prompting consultation with our service. Any consultation reports from neurologists or other specialists related to this pain should also be faxed to our office.

Back pain
Back pain is also a very common complaint among children. We may evaluate the patient's medication regimen and adjust as appropriate. We also provide interventional techniques for pain refractory to medical management such as epidural steroid injections. We expect that the referring provider will attempt basic management of pain, with failure or insufficient management of pain prompting consultation with our service. Any consultation reports with neurologists, orthopedic surgeons, or other specialists related to this pain should also be faxed to our office. Any relevant imaging reports should also be sent.

Complex regional pain syndrome (reflex sympathetic dystrophy)
This form of neuropathic pain is sometimes seen after surgical procedures or injuries. We may evaluate the patient's medication regimen and adjust as appropriate. We also provide interventional techniques for pain refractory to medical management, such as stellate ganglion blocks or lumbar sympathetic blocks.

Chronic opioid management
Children with chronic disease often require chronic opioids for pain control. When these opioid regimens become complex, our service may be able to help with management. We may evaluate the patient's medication regimen and adjust as appropriate. For safety, the patient may be subject to random drug screens and tracking of controlled substance prescriptions on federal and/or state databases. We also require the patient's family to sign an opioid contract during the period we manage these prescriptions. With this contract, we expect that our clinic will be the sole provider of opioid medications with monthly repeat evaluations prior to additional opioid prescriptions. Very importantly, we expect to transfer care back to the referring physician when a safe and acceptable regimen has been established for further prescription management.

Neuropathic pain
In addition to CRPS, other forms of neuropathic pain or pain refractory to classic pain medications, such as trigeminal neuralgia, may prompt referral to our clinic. We may evaluate the patient's medication regimen and adjust as appropriate.

Abdominal pain
Chronic abdominal pain may be debilitating to the child and the family. We may evaluate the patient's medication regimen and adjust as appropriate. We expect the referring provider will attempt basic management of pain with failure or insufficient management of pain prompting consultation with our service. We expect pediatric gastroenterologists will fully evaluate, examine, and study the patient's pain, with negative workups prompting consultation with our service. We generally provide multidisciplinary therapy, including child psychiatry and/or behavioral medicine consultations.


Last Edited: June 13, 2016
Valued Participant of Vanderbilt Health Affiliated Network