Understanding Pediatric Youth: Pain
Pain is something that we all experience in different ways throughout our lives. Whether it be emotional or physical, dull or sharp, sudden or chronic, pain takes a toll on us. There are dozens of words that can be used to describe pain, and even more ways that it can be experienced. Unfortunately for pediatric youth, pain can be an everyday part of life, or something that can happen anytime. Here, I want to talk briefly about pain in this group, and why it is important.
Although we talk about pain as a single thing, there are many different forms of pain that a person can experience. When talking with someone who experiences pain regularly, there are a number of things we want to take into account. First is how often pain is experienced (e.g., monthly, weekly, daily). As you can imagine, more frequent pain can be more stressful and difficult to manage for the person experiencing the pain.
Another important component to the pain is how long it lasts. Sudden pains that subside quickly can be bothersome, but pain that lingers for hours, days, weeks at a time can be draining. Some illnesses, like sickle cell disorders, can lead to very long-lasting pain of varying intensities.
Intensity can be very difficult to put into words, but we can imagine the effects of pain at different levels. Getting pinched is a very different experience from pain that makes it difficult to even think. Comparing the intensity of one pain to the intensity of another can sometimes be difficult, though, due to the different qualities of pain.
As I've been saying, there are dozens of words that can be used to describe pain. Just read through this list, and you can probably imagine a form of pain that fits: squeezing, pressing, crushing, pinching, tingling, pulsating, burning, sharp, dull, stinging, deep, focused, aching. The list goes on, and we all experience variations of these pains in our lives. Because of the difficulty of putting words to pain, and our uncertainty of whether one person's "pressing" pain is the same as another's, it's unclear if/how different forms of pain affect us.
Finally, pain can occur in many different places throughout the body, which changes our experiences of them. Pain in our foot may prevent us from moving, whereas a headache or migraine makes it difficult to think and stomach pain can make it difficult to eat.
All of these different factors come into play when we're working with pain. Of course, pain never happens by itself. By making it difficult to do other tasks, it can be a cause of some other challenges we see in the pediatric population (e.g., physical impairment). There are also challenges that come with pain being invisible. When it all combines together, a number of undesirable outcomes can occur.
Effects of Pain
While we're still beginning to understand the impacts of pain on children, there are two major findings I've seen that are concerning. First, pain is sometimes associated with more difficulties at school. As part of this, school absences are more common for youth who experience pain, so they do not have as much exposure to the class material.
But being absent from school has another negative consequence for kids: less time around friends. By having less social time, and potentially being less able to participate in after-school activities (e.g., sports), these children can be at a heightened risk of mental health challenges.
Then there is the general stress that comes with experiencing pain. Even though it's invisible, it can take a heavy toll on a person's energy and mood. That may be why pain is something we often are asked to help with as pediatric psychologists.
What Helps with Pain
There are specialized pain clinics who could give a lot more detail about how to effectively address pain. I have not had that specialized experience, but there are several things in my own work that have been helpful for patients in managing pain.
First, a very common skill children naturally use is distraction. Now, this is not to say that pain should be completely ignored, as pain can mean something is happening that needs to be addressed medically. But if a child is found to be medically okay, then distraction (e.g., coloring, playing games) can be helpful in reducing how intense the pain feels.
Second, mindfulness (mainly for adolescents) can be helpful. As part of this, guided imagery can be especially beneficial, alongside things like deep breathing and relaxation techniques. To practice guided imagery, it can be helpful to have the teenager describe a happy memory, then guide them through reliving it in their mind as vividly as possible (e.g., "try to remember the feel of the sun on your skin"). One of the reasons that these skills help is by reducing anxiety (which can intensify pain). Another is that it helps draw focus away from the pain, much in the same way distraction does.
There are also the obvious options of medical interventions. But medical interventions are not always the preferred route, and/or they do not always fully address the pain a child is experiencing. In order to determine the best approach to helping a child with pain, it's important to consult with a physician, psychiatrist, and/or psychologist with training in pain management for children.
Pain is a very real part of human life, but some experience it more strongly and more often than others. Pediatric youth are especially familiar with pain, and it can be very challenging for them to cope with painful experiences. Even though it's an invisible struggle, it's important to be mindful of any pain that a child may be experiencing. There are also several things that you can do to help such a child.
Do you have any personal experience with this? What have you found helpful for managing pain in your life? Let me know in the comments!