Saskatoon-based pediatrician Dr. Krista Baerg (right) and research coordinator Casey McMahon are raising awareness about chronic pain disorders, such as complex regional pain syndrome (CRPS) in children during National Pain Awareness Week (Nov. 4-8). Photo: Kristen McEwen, USask College of Medicine.

When pain in children is caused by more than just an injury

If a child experiences pain after an injury for a longer amount of time than expected, it could be due to a pain disorder called complex regional pain syndrome (CRPS).

By Kristen McEwen
Physical therapist JoAnn Nilson (right) demonstrates the use of a mirror box on Monday as a way to support pain management with graded motor imagery. The display was part of the booth set up at JPCH as part of CRPS Awareness Day. Photo by Kristen McEwen

College of Medicine associate professor of pediatrics Dr. Krista Baerg and research coordinator Casey McMahon are studying CRPS in children, a pain disorder that also affects adults. 

“It’s a clinical syndrome — often there’s a delayed diagnosis,” Baerg explained. “Initially, people think the pain is due to a sprain, or a fracture, but it doesn’t heal within the expected time frame. Diagnosis relies upon recognizing the signs and symptoms.” 

Unusual swelling and a change in colour around the injury is a sign that the pain is related to the pain disorder.

CRPS incident rate is 5 to 26 cases per 100,000 adults. The same syndrome occurs in children, but not much else is known, including the incidence rate. 

Over the past two years, Baerg and McMahon have used the Canadian Paediatric Surveillance Program to study the new cases of CRPS across the country. 

This program is made up of a network of nearly 2,800 pediatricians across the country. Once a month, the Saskatoon-based team would use the program and email affiliated pediatricians and ask that they record and report new cases of CRPS. This research is funded by the Chronic Pain Network, a CIHR funded patient oriented chronic disease network.

Now with the surveillance portion of the study complete, Baerg and McMahon are starting to go through the data that has been collected. Preliminary data has indicated that CRPS tends to affect the lower limb in children, opposite of what is found in the adult population. 

“We want people to better understand how this syndrome presents in pediatrics so we can promote early diagnosis and intervention and find out more about it in children,” Baerg said. 

“We hope that early diagnosis and intervention during adolescence could prevent the transition from acute to chronic pain,” Baerg added. 

“Chronic pain costs more in lost productivity and health compared to cancer and heart disease combined,” Baerg said. “It’s a really significant problem.” 

Chronic pain in children might be more common than you think. One in five children and youth experience chronic pain, with girls most commonly affected. Chronic pain includes headaches, abdominal pain, back pain and limb pain. 

One in 20 kids will have a pain-related disability by the time they reach adulthood. 

National Pain Awareness Week

To help raise awareness about pain in children, including CRPS, Baerg and McMahon have organized a series of events as part of National Pain Awareness Week, which takes place from Nov. 4-8. 

By increasing knowledge about pain management and resources, the week will serve as an opportunity for health care professionals to learn more about managing pain in children.

A multimodal approach for chronic pain is available at the Jim Pattison Children’s Hospital Interdisciplinary Pediatric Complex Pain Clinic

National Pain Awareness Week was first established by the federal government in 2004 to occur during the first week of November. The week recognizes the cost of chronic pain on the people who experience it. 

Check out the Pain Awareness Week events being held in Saskatoon: 


Nov. 4
11 a.m. to 1 p.m.
Complex Regional Pain Syndrome (CRPS) Awareness Day #crpsOrangeDay|
At JPCH Main Floor
See a mirror box and meet a Physical Therapist 

Nov. 5 
9 a.m. to 1 p.m. 
Coping Circus: Needle Pain Comfort Strategies
At JPCH Main Floor
Meet Nurse Mason (MEDi Robot) and a Child Life Specialist 

Nov. 6 
12:15 p.m. to 1 p.m. 
Staff Lunch & Learn: Nitrous Oxide
At JPCH Room 2395
Learn about policy and see equipment

Nov. 7 
9 a.m. to 4 p.m.
Pain Research Highlights
Follow us on Twitter #StopPain 

Nov. 8
12:15 p.m. to 1 p.m
Staff Lunch & Learn: Nitrous Oxide 
At JPCH Room 2395
Learn about policy and see equipment