Ask the Doctor: Kids Have Pain Too!
This is another article on pain endured by "special populations". So far we talked about pain in older individuals, and pain in women. In 2005, the International Organization for the Study of Pain formed a "special interest group" in pediatric pain to promote education, awareness and research in kids' pain, since children are not immune to it. Pain is universal. Children and young people suffer painful life-threatening diseases such as cancer just like adults.
Pain in children can also come from injuries, surgery, burns, infections, diseases and the effects of war, terrorism, and violence. Children are submitted to painful procedures by doctors and nurses during investigations or treatment of diseases. Additionally, many kids suffer from chronic pain or pain that returns frequently.
Even newborn and premature babies feel pain, believe it or not this is a fairly new realization. Experiments in baby mice and puppy dogs showed us that pain experienced very early in life can have life altering and long lasting consequences. Young children who have poorly treated pain early in life experience profound effects on social and physical development. The important thing to understand about pain experienced early in life is that it can cause permanent changes in the nervous system that will affect future pain experience and development.
Children remember pain. This may make them avoid future medical care because of painful experiences in a hospital or clinic. Kids' pain affects their parents, family, and caregivers. Caring for a child with chronic pain brings emotional and financial stress to the family.
Chronic pain fairs better if treated early in life. Most pain in children can be prevented, treated, or at least reduced with medications that do not cost much, psychological, and/or physical techniques. In spite of this, most children in the world do not receive adequate treatment.
Why is this happening? First, children's pain can be difficult to recognize. At times parents and caregivers cannot identify pain because the kids may continue to play or sleep even if they have significant pain. Asking the child about pain gives the most important information, but we often have to use specific tools and approaches, particularly when we deal with newborn, very young children and children with developmental disabilities who are unable to report their own pain in words. Health care providers and parents should know that children can normally receive most of the same medications as adults (provided the dose is reduced to match the size and age of the child and for the amount of pain felt).
There is much to be said about children's pain in general and chronic pain in particular. I would like, however, to touch on a couple of important concepts relating to chronic pain in children and youth. Parents and other caregivers such as grandparents, should remember that the presence of an individual with chronic pain in the family may serve as a "role model" for a young child with life-long consequences. Kids who grow up in such families tend to complain of several pain symptoms later on in adult life. On the other hand, when a child is in pain, research has shown that reactions of the caregivers affect greatly perception and expression of pain in the long run as kids grow up to become adults.Angela Mailis Gagnon, MD, MSc, FRCPC(PhysMed)Director, Comprehensive Pain Program,Senior Investigator, Krembil Neuroscience CentreToronto Western Hospital,Chair ACTION Ontario www.actionontario.cawww.drangelamailis.com