When you hear the phrase “chronic pain,” I would bet that nine times out of ten you will think of adults. Arthritis, multiple sclerosis, irritable bowel syndrome, endometriosis are all illnesses that primarily plague adults, however, and unfortunately, there are many pain-related illnesses that affect children. Some of these illnesses include fibromyalgia, back pain, abdominal pain, juvenile arthritis, migraine and tension headaches, and sickle cell disease among others. Pain serves a protective purpose; it lets us know when something is harming our body so we can do something about it. When pain is prolonged, repeated, and extends far beyond when an injury is healed (usually 3 months or more), it no longer serves a protective purpose. This is chronic pain. The biology behind chronic pain is that changes in the Central Nervous System and the brain cause pain to persist beyond what is necessary. Physical and psychological stressors can affect the ways neurons connect and communicate with each other, and irregular firing patterns can spread pain stimuli. Chronic pain should not be perceived as purely biological but should be treated from a biopsychosocial perspective because of the extreme influence of pain disorders on psychological and social well-being.
Chronic pain is highly comorbid with anxiety and depression, and 22% of individuals with chronic pain are reported to also suffer from depression. Unsurprisingly, the risk for depression and other co-occurring illnesses increased with pain frequency and severity. The prevalence of chronic pain also escalates with puberty due to hormonal changes and is more common among females. As stated previously, chronic pain is a biopsychosocial problem and influences a child’s physical, social, emotional, and cognitive development. Pain can be debilitating and can prevent children from participating in activities, focusing on school, and participating socially. Chronic pain can also cause difficulty performing basic life functions. In addition, having a child who suffers from chronic pain is life-changing for the entire family and alters family dynamics dramatically. Parents often feel helpless that they cannot take away or solve their child’s pain. Siblings can feel confused, vulnerable, and emotionally neglected.
Because chronic pain and psychological issues are highly comorbid, it is crucial that children suffering from chronic pain or illness receive mental health treatment. It is also highly probable that children will experience some capacity of chronic pain in adulthood, so implementing coping strategies in childhood Cognitive behavioral therapy (CBT) has proven to be useful in treating individuals who suffer from chronic pain due to the emphasis on thought cognitions and beliefs. Beliefs are so powerful that they can influence pain perception and treatment response. Furthermore, pain catastrophizing is a prevalent cognition among those with chronic pain and includes magnification, rumination, and a negative mindset about the pain. Catastrophizing has been proven to be a significant predictor of pain and quality of life, especially in children. Acceptance and commitment therapy, tapping, and mindfulness techniques have also been shown to be helpful to treat psychological disorders associated with chronic pain.
In conclusion, chronic pain is not untreatable. With concurrent physical and mental health treatment, relief is possible, and symptoms are manageable. Therapy will help your suffering child to form a toolkit of coping strategies, process emotions, and uncover negative cognitions. Therapy can also support parents and the entire family in facing a life-altering diagnosis. Through this unimaginably challenging time, remember that asking for help is a sign of strength and a step towards healing.