American College of Sports Medicine releases guide for pain management in youth athletes
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Top physicians in sports medicine recommend the use of nonpharmacologic treatments before prescription opioids for management of acute and chronic pain in youth athletes, according to a recently published consensus statement.
Stanley A. Herring, MD, FACSM, and colleagues at the American College of Sports Medicine (ACSM) have released an updated overview of pain management issues for team physicians specifically in high school and collegiate athletics. The statement covers strategies for diagnoses, interventions and medications for the treatment of acute and chronic pain.
“Nonpharmacological treatment is fundamental and should be performed early to manage pain,” Herring and colleagues wrote in the study. “Between 1994 and 2007, the rate at which opioids are prescribed to adolescents [aged 15 years to 19 years] has doubled,” they wrote.
In the diagnosis of acute pain, team physicians should be aware of both the athlete’s clinical and pain history; psychological factors, such as depression and anxiety; importance of sport to the athlete; parent, coach and peer pressures; as well as physical and imaging testing. Herring and colleagues also covered medication protocol such as NSAID choice for the treatment of acute pain.
When pain persists beyond 6 weeks to 12 weeks, the physician should transition to chronic pain management, which focuses on improving physical function and decreases reliance on the health care system, Herring and colleagues wrote.
“The diagnostic process should be revisited to identify any persisting anatomical or medical sources of pain or overlooked psychosocial contributors to pain. The chronic pain diagnostic process should include expanded emphasis on psychosocial factors and home and school environments that may contribute to the athlete’s distress,” they added.
Herring and colleagues concluded by outlining preoperative, intraoperative and postoperative pain management interventions and stressed the importance of a multimodal approach.
“Providing education to athletes, parents/guardians, coaches and other members of the athlete care network is important in influencing the athlete’s response to pain,” they wrote.
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Herring SA, et al. Medicine & Science in Sports & Exercise. 2020;doi:10.1249/MSS.0000000000002333.
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