One in fifty children and adolescents live with severely
debilitating and recurrent pain but there is an embarrassing
lack of data on the best ways to treat them, according to
As many as 15 per cent of children suffer from headaches,
abdominal and musculoskeletal pain but two per cent of children
have pain symptoms that can be severe enough to interrupt
sleep, restrict physical activity and prevent them from
Studies have shown that children suffering with this kind
of chronic pain frequently become emotionally distressed
and have a heightened sense of vulnerability, which can
have a major impact on parents and siblings.
But despite the impact of chronic pain in children and
adolescents there is a lack of evidence to guide clinical
practice in this complex area, and few paediatric centres
have chronic pain management programmes.
Many people used to think that chronic pain was a uniquely
adult problem, but recent epidemiological studies have shown
that a number of children are severely affected by pain,said
Professor Christopher Eccleston, Director of the Pain Management
Unit at the University of Bath.
There can be a significant effect on the child's family
and our studies have shown that many parents of children
who suffer with chronic pain report higher than normal levels
of anxiety, as well as marital and financial problems.
Many parents that we have spoken to were highly distressed
by their inability to alleviate their childs pain and felt
that this contradicted their view of a parent as someone
who can make things better.
Whilst many children in chronic pain can be treated by
their family doctor, the medication they prescribe is selected
on the basis of on data extrapolated from adults, and the
evidence for its effectiveness in children is limited.
Controlled trials with a focus on safety, as well as efficacy,
are urgently needed for all conditions of childhood and
adolescence that are characterised by chronic or recurrent
pain, said Professor Eccleston.
Chronic pain in children is an important problem and more
action is urgently required to overcome the embarrassing
lack of data on childhood pain.
The incidence of chronic pain in children is similar to
that of adults but our knowledge of how to help children
cope with chronic pain is severely underdeveloped.
Given the probability that that many children with untreated
chronic pain will grow into adults disabled by chronic pain,
this lack of knowledge potentially has a high societal cost.
Many doctors dealing with children in pain become concerned
about missing a serious underlying disease and so invest
time and energy looking for a serious condition and referring
to specialists for further evaluation.
During this time in a diagnostic vacuum, the child often
receives little appropriate pain management which can be
incredibly frustrating for all concerned, said Professor
Inaccurate and unhelpful diagnoses of functional or psychosomatic
pain can fuel fear and frustration in children and their
Families often interpret these labels as blaming them for
the childs pain and the labels tend to reinforce their need
to move from doctor to doctor in search of a different diagnosis
Research by the Pain Management Unit has shown that even
for children and adolescents with the most severe pain and
disability, it may be possible to reduce the impact of pain
on the lives children and their families through psychologically-based
A recent evaluation of an intensive interdisciplinary programme
of cognitive behaviour therapy developed by the Pain Management
Unit for adolescents with chronic pain showed that it was
effective at improving physical, psychological and social
scores - and resulted in 40 per cent of the children returning
to full time school.
The emotional condition of parents can have an important
role in the success of this type of treatment, but their
untreated depression may be both a clinical problem of its
own and a barrier to effective delivery of treatment to