Table 4.

Summary of the pediatric chronic pain management.

Author	Behavioral Treatment	Treatment Symptomatic	Complementary Therapies	Multidisciplinary Team
Al-Khotani et al. (2015) [45]	-Not provided	-Not provided	Not provided	-Not provided
Bhatia et al. (2008) [36]	-Cognitive therapy: 17.7%	-Medication: 41.3% -Physiotherapy: 23.6% -Nerve stimulation techniques (TENS): 17.7% -Nerve blocks: 1.2% -Most pain physicians use a combination of three or more modalities.	Not provided	83% of pain physicians and 55% of general practitioners referred patients to the hospital -Pediatricians: 79% -Orthopedic surgeons: 70% -General practitioners: 58% -Oncologists: 13% -Neurologists: 12% -Pediatric surgeons: 11% -15% of pain physicians specifically mentioned that specialized pediatric centers with multidisciplinary teams (pediatricians, child psychologists, and physical therapists) are the optimal clinical
Edwards et al. (1994) [41]	-Inform parents that everything is normal: always (SD 0.4) -Reassure parents and child that there is no illness: always (SD 1.1) -Raise the possibility that emotions or psychological factors are playing a role: always (SD 1.1)	-Medication: sometimes (SD 1.8)	Not provided	-Refer to GI specialist: rarely (SD 1.4) -Refer to MHP: rarely (SD 1.5) -Refer to psychologist: rarely (SD 1.4) -Refer to psychiatrist: rarely (SD 1.4)
Glazebrook et al. (2009) [44]	Not provided	Not provided	Not provided	-Physicians perceived a greater need for support than nurses Nurses perceived a greater need for support than medicine related professionals
Heinsch et al. (2019) [39]	-Physician recommendations that -consistent with a cognitive behavioral treatment for pain: 29.8% Written information: 47.4%	-Anti-diarrhoeal agents (loperamide): 11.1% -Metronidazole (empiric course): 9% Probiotics: 34.6%	-Dietary modifications suggested by the physician: 34.3% Peppermint oil: 17%	Refer to a paediatric gastroenterologist: 30.5% Refer to a dietitian: 46% Refer to a psychologist or counsellor: 15.9% Referral for hypnotherapy: 2.1%
Høie et al. (2017) [5]	Not provided	All the nurses stated that adolescents consumed painkillers such as paracetamol.	Not provided	Not provided
Koechlin et al. (2022) [43]	Not provided	Not provided	Many participants had also referred patients to hypnotists, acupuncturists, and practitioners of alternative medicine.	-Refer to another specialist: 75% -Refer to a service specializing in pain in children and adolescents: 90% -The most frequently referred specialists were: Gastroenterology and hepatology: 35.3% Neuropediatrics: 34.12% Orthopaedics: 29.4% Also to non-pediatric pain specialists (internal medicine, rheumatology, neurology, psychiatry, and anesthesia.
Miro et al. (2020) [35]	Not provided	Not provided	Not provided	-6% of general practitioners and 24% of pediatricians were members of a multidisciplinary group. 85% reported that there was no coordination between primary and specialized care.
Riaño et al. (1998) [42]	Not provided	Medication: -Acetylsalicylic acid: 12% -Paracetamol: 18% -Paracetamol-codeine: 37% -Metamizole (dipyrone): 28% -Other NSAISD: 24% -Morphine or other opioiSD: 30% Tricyclic antidepressants: 3%	Not provided	Not provided
Sawni et al. (2007) [37]	Not provided	Not provided	96% believe their patients are using some form of CAM 30% reported using CAM therapies on their patients. The most common CAM therapies were: -Prayer for healing: 9% -Relaxation: 9% -Massage therapies: 8% -Imagery: 6% Herbs, megavitamins, lifestyle diet, biofeedback: 5%	Not provided
Schlarb et al. (2011) [40]	-Counseling, Support and Reassurance: 20.1% -Psychotherapy: 3.8% -Behavioral Interventions: 3.3% Relaxation: 2%	-Medication and physical therapy: 11.1% Treatment for Constipation: 2.6%	6.5% Homeopathy, Naturopathy	-39.6% Request psychological treatment in children with recurrent abdominal pain. 2% Referral to Medical Specialist
Schurman et al. (2014) [33]	-74% Change of Lifestyle. -61% Peace of Mind. -51% Positive Coping. -26% Interventions at School. -12% Biofeedback Referral. 2% Dairy.	-Laxatives: 30% -Selective serotonin reuptake inhibitor: 6% -AntaciSD: 6% -Imipramine, Elavil: 4% Probiotics: 4%	-53% Fiber Supplementation. 6% Herbal Supplements.	-54% Gastrointestinal specialist referral. 80% Family Request 70% Testing 60% Pain does not Decrease 50% Pain Increases 60% Uncertainty in Treatment 5% Routine Referral 2% Red Flag Symptoms 1% other -50% Mental Health Practitioners referral. 80% consider pain to have a psychological basis. 50% family request. 20% testing. 30% pain does not decrease or increases. 30% uncertainty in treatment. 2% routine referral. 4% request for collaboration. 3% unimportant findings by the GI specialist. 2% psychological symptoms: 8% never or rarely 1% other
Thompson et al. (2010) [38]	Not provided	Medication -NSAISD almost always: 66.9% -Acetaminophen almost always: 61.7% -Intermittent opioiSD: 38.1% -Permanent opioiSD: 25.4% -Patient-centered analgesia: 17.7% Massage almost always: 9.5% -Acupuncture almost always: 4.6%	Not provided	The professional responsible for the child in pain should be: -32.3%: pediatricians -15.8% Other professionals besides him/herself. -58.1% Pediatric pain specialist. -39.6%: Other specialist (pediatric hematologist or oncologist) -26.1%: Local hospice -6.3%: Adult pain specialist 2.3%: Local emergency services
Youssef et al. (2007) [34]	Not provided	Not provided	Not provided	-84% believed that communication with physicians about RAP is poor -70% of the respondents believed that a more extensive evaluation by the physician was needed