Chronic Pain, Pediatric

Chronic pain is a type of pain that lasts or keeps coming back for at least 3–6 months. Your child may have headaches, pain in the abdomen, or pain in other areas of the body. Chronic pain may be related to an illness, such as fibromyalgia or complex regional pain syndrome. Chronic pain may also be related to an injury or a health condition. Sometimes, the cause of chronic pain is not known.

Chronic pain can make it hard for your child to do daily activities. If not treated, chronic pain can lead to anxiety and depression. Treatment depends on the cause and severity of your child's pain. Your child may need to work with a pediatric pain specialist to create a treatment plan. The plan may include medicine, counseling, and physical therapy. Many children benefit from a combination of two or more types of treatments to control their pain.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child's health care provider.
• Ask your child's health care provider if the medicine prescribed to him or her:
  • Requires your child to avoid driving or using machinery, if this applies.
  • Can cause constipation. You may need to take these actions to prevent or treat constipation:
    • Give enough fluid to keep his or her urine pale yellow.
    • Give over-the-counter or prescription medicines.
    • Give foods that are high in fiber, such as beans, whole grains, and fresh fruits and vegetables.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

Treatment plan

• Gentle, regular exercise.
• Having your child eat a healthy diet that includes foods such as vegetables, fruits, fish, and lean meats.
• Cognitive or behavioral therapy that changes the way your child thinks or acts in response to the pain. This may improve how your child feels.
• Working with a physical therapist.
• Meditation, yoga, acupuncture, or massage therapy.
• Aroma, color, light, or sound therapy.
• Local electrical stimulation. The electrical pulses help to relieve pain by temporarily stopping the nerve impulses that cause your child to feel pain.
• Injections. These deliver numbing or pain-relieving medicines into the spine or the area of pain.

Lifestyle

• Ask your child's health care provider whether you or your child should keep a pain diary. The health care provider will tell you what information to write in the diary. This may include when your child has pain, what the pain feels like, and how medicines and other behaviors or treatments help to reduce the pain.
• Consider having your child talk with a mental health specialist about ways to manage chronic pain.
• Consider having your child join a chronic pain support group.
• Help your child to control or lower his or her stress levels. Talk with the health care provider about ways to do this.
• Let your child's teachers and other caregivers know your child has chronic pain.

General instructions

• Learn as much as you can about how to manage your child's chronic pain. Ask your child's health care provider if an intensive pain rehabilitation program or a chronic pain specialist would help.
• Check your child's pain level as told by your child's health care provider. Ask the health care provider if you can use a pain scale to determine your child's pain level.
  • For young children, consider using a rating system with pictures of faces.
  • Older children can use a number system to rate their pain.
• It is up to you to get the results of any tests that were done. Ask your child's health care provider, or the department that is doing the tests, when the results will be ready.
• Keep all follow-up visits as told by your child's health care provider. This is important.

Contact a health care provider if:

• Your child's pain gets worse.
• Your child has new pain.
• Your child has trouble sleeping.
• Your child has trouble doing his or her normal activities.
• Your child's pain is not controlled with treatment.
• Your child has side effects from pain medicine.
• Your child feels weak.

Get help right away if:

• Your child has thoughts of self-harm or of hurting others.
• Your child loses feeling or has numbness in his or her body.
• Your child's pain suddenly gets much worse.
• Your child develops shaking or chills.
• Your child develops confusion.
• Your child develops chest pain.
• Your child has trouble breathing or has shortness of breath.
• Your child passes out.
• You notice any other changes that show that your child's condition is getting worse.

• Call your local emergency services (911 in the U.S.).
• Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
• Text the Crisis Text Line at 741741 (in the U.S.).

Summary

• Chronic pain is a type of pain that lasts or keeps coming back for at least 3–6 months.
• Chronic pain may be related to an illness, injury, or a health condition. Sometimes, the cause of chronic pain is not known.
• Treatment depends on the cause and severity of your child's pain.
• Many children benefit from a combination of two or more types of treatments to control their pain.
• Follow your child's treatment plan as told by the health care provider.