Children and Pain
Disparities in Pain - Children
By: Elisa Martinez
Chronic pain is a condition that affects people of all ages. Though pain is mostly thought of as an adult problem, children also are affected by chronic pain – sometimes more so as this is a condition that is mostly ignored or overlooked in children.
Chronic pain in adolescents has slowly gained notice over the past 20 years; however, pediatric pain is still poorly understood and not well documented. Simply, pain is not as widely accepted a problem in children as it is in adults or the elderly population. Researchers estimate that roughly 15% to 20% of the pediatric population has pain, but the effects of pain on children and their families has not been studied.
Pediatric pain is usually caused by headache, abdominal pain and musculoskeletal pain. Girls report more pain than boys and pain reports peak at age 14.
Pain in children often is overlooked and therefore not treated. This is usually because a family doctor may be looking for other, more serious causes for the pain. Referrals to specialists, who may also not find a diagnosis for the pain, can leave children without proper pain management or treatment. The constant search for the reason why pain is occurring often leaves children in pain and without proper treatment.
Over time, chronic pain in children can lead to more serious physical, emotional, psychological and social effects. Children may experience physical disability, anxiety, and sleep problems because of their pain. They also may be absent from school and withdraw from their friends. Chronic pain in children can put major stress on parents and the family and fracture family units.
It is important to remember that children who experience chronic pain will most likely become adults with chronic pain. The cost of pain in adults is high and its implications on quality of life and on the health care system are damaging. Accepting chronic pain in children as a real problem and attempting to treat it at a young age may help decrease rates of adult pain in the future.
Disparities
Clinical guidelines to treat pediatric pain are inadequate. Pain medications are used but evidence to support the use of such medications is based on adult studies. Evidence of effectiveness of pain medications in children is not known; however, studying pain medications in children is an extremely risky undertaking. Despite the risk, some researchers are calling for controlled trials for children with a focus on safety as well as effectiveness.
Some studies have shown psychological treatment to be effective in children. For headache, psychological treatment seems to be cost-effective and can be delivered in community-settings by trained non-psychologists; however, these treatments are only for pain relief and not for treatment of other factors such as school and family functioning.
Pediatric pain is an important problem that has gained notice in the past 20 years. Assessments of pain in children have improved and treatments are more widely used; but information, education, research and clinical guidelines are not available to those who need it – doctors and families – creating a disparity not only in treatment but in information. This is a problem that has effects that go beyond the physical, affecting the emotional status of children and affecting parents and families.
Elisa Martinez graduated with a master's degree from Drexel University School of Public Health in Philadelphia, Pa., in May 2006. She is now the project manager for tobacco cessation research at Fox Chase Cancer Center.
Adolescent Pain
Chronic pain in adolescents has slowly gained notice over the past 20 years; however, pediatric pain is still poorly understood and not well documented. Simply, pain is not as widely accepted a problem in children as it is in adults or the elderly population. Researchers estimate that roughly 15% to 20% of the pediatric population has pain, but the effects of pain on children and their families has not been studied.
Pediatric pain is usually caused by headache, abdominal pain and musculoskeletal pain. Girls report more pain than boys and pain reports peak at age 14.
Consequences
Pain in children often is overlooked and therefore not treated. This is usually because a family doctor may be looking for other, more serious causes for the pain. Referrals to specialists, who may also not find a diagnosis for the pain, can leave children without proper pain management or treatment. The constant search for the reason why pain is occurring often leaves children in pain and without proper treatment.
Over time, chronic pain in children can lead to more serious physical, emotional, psychological and social effects. Children may experience physical disability, anxiety, and sleep problems because of their pain. They also may be absent from school and withdraw from their friends. Chronic pain in children can put major stress on parents and the family and fracture family units.
It is important to remember that children who experience chronic pain will most likely become adults with chronic pain. The cost of pain in adults is high and its implications on quality of life and on the health care system are damaging. Accepting chronic pain in children as a real problem and attempting to treat it at a young age may help decrease rates of adult pain in the future.
Disparities
Clinical guidelines to treat pediatric pain are inadequate. Pain medications are used but evidence to support the use of such medications is based on adult studies. Evidence of effectiveness of pain medications in children is not known; however, studying pain medications in children is an extremely risky undertaking. Despite the risk, some researchers are calling for controlled trials for children with a focus on safety as well as effectiveness.
Treatment Options
Some studies have shown psychological treatment to be effective in children. For headache, psychological treatment seems to be cost-effective and can be delivered in community-settings by trained non-psychologists; however, these treatments are only for pain relief and not for treatment of other factors such as school and family functioning.
Pediatric pain is an important problem that has gained notice in the past 20 years. Assessments of pain in children have improved and treatments are more widely used; but information, education, research and clinical guidelines are not available to those who need it – doctors and families – creating a disparity not only in treatment but in information. This is a problem that has effects that go beyond the physical, affecting the emotional status of children and affecting parents and families.
Elisa Martinez graduated with a master's degree from Drexel University School of Public Health in Philadelphia, Pa., in May 2006. She is now the project manager for tobacco cessation research at Fox Chase Cancer Center.