Managing Chronic Pain in Children

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Your child has been complaining of headaches for weeks. The headaches are happening more often and she is having trouble attending school and hanging out with friends.  She hurts when she wakes and stays in bed most of the day.  You have received a medical diagnosis but still the pain persists. What do you do?

Chronic pain is a condition that affects many children and adults. Defined as pain lasting more than 12 weeks, conservative estimates suggest that 20-35% of children and adolescents are affected by chronic pain worldwide. Chronic pain may arise from an initial injury or there may be an ongoing cause, such as chronic illness, thus chronic pain is often persistent and can last for months or even longer.

Chronic pain can interfere with many areas of daily functioning including school attendance and performance, social relationships, and involvement in enjoyable activities. Other health problems, such as sleep disturbance, decreased appetite, and mood changes often accompany chronic pain. These symptoms can lead to reduced functioning, or difficulty “being a kid.” For some, reduction in functioning can lead to a downward spiral of disability out of proportion to what the medical tests show.

Parents serve as the primary support and advocate for children. This role can feel increasingly challenging as symptoms persist and/or worsen. Seeking treatment for your child to improve adjustment and coping is essential to improving functioning. Cognitive-behavioral therapy (CBT) is the gold standard of treatment to address the underlying physical, psychological and social factors that play a role in chronic pain.

Parent plan of action:

·      Investigate and understand symptoms and resulting medical diagnoses

·      Understand how symptoms impact your child’s daily functioning

·      Understand impact on mood, including anxiety related to illness and pain

·      Avoid questions focusing on pain

·      Avoid excessive focus on rest, rather increase movement

·      Focus on small successive goals to improve functioning

·      Focus on tasks accomplished rather than those avoided

·      Provide support for coping with related stressors (e.g. school plan, peer socialization, out of house)

·      Focus on routines for your child’s day, including sleep/wake and exercise

·      Seek services with a mental health professional familiar with chronic pain or illness

Parenting is a tough job and can become even more challenging when your child experiences chronic pain. Seek help if you or your child are feeling overwhelmed. Healthy adjustment and coping are possible.

Dr. Lindsay Clendaniel

Lindsay Clendaniel, PhD is a pediatric psychologist and Director at Thinking Tree Psychology. She specializes in the treatment of children, adolescents and young adults with anxiety and health-related adjustment issues, with particular expertise in pain management and treatment of chronic headache and functional gastrointestinal illness. Dr. Clendaniel has presented research at national conferences related to the topic of pain management and has also authored several articles and book chapters related to the management of functional gastrointestinal illness.