How Adverse Events Affect Children With Chronic Pain

March 17, 2022 / Thomas Cohn, MD

Children with chronic pain who experience adverse childhood events (ACEs) are more likely to suffer an increase in symptom severity, according to new research. This suggests that chronic pain should be monitored even more closely if a child is subjected to difficult or stressful events.

For the study, researchers grouped children with chronic pain conditions or rheumatic diseases into one of three groups:

Pain with zero adverse childhood events
Pain with one adverse childhood event
Pain with two or more adverse childhood events

Although the researchers didn’t spell out exactly what type of adverse events were tracked for the study, they did mention that a wide array of adverse events were used as data points. They said traumatic experiences included a range of physical, mental and sexual abuse, and things like divorce or family mental illness.

“The results indicate that children with chronic pain and/or rheumatologic diseases who are exposed to ACEs are at increased risk of worse functional disability, greater pain-related symptomatology, and a higher burden of co-morbid mental health conditions,” researchers wrote. Patients who had experienced two or more adverse childhood events had “more somatic symptoms, worse functional disability, and a higher proportion of mental health conditions.”

Mental Health And Chronic Pain Symptoms

As we’ve talked about at length on the blog in the past, chronic pain and your mental health are closely connected, so it should come as no surprise that children with chronic pain who experience traumatic life events would be at risk for more severe pain symptoms. Chronic pain is not just a physical condition, and mental factors like stress or anxiety can absolutely make physical symptoms worse.

While the study only focused on children, the results should likely be applied to all populations that are dealing with a chronic pain condition. If you experience an adverse event in your life, don’t be surprised if your pain or your symptoms worsen. It’s not ideal, but it’s a direct result of this new mental stress and fatigue.

The only bright spot about this news is that it helps us understand that we need to be aware of the physical issues that may come along with a psychologically traumatic event. If we’re aware of how these events can impact our physical health, we can help patients get the care they need sooner or develop some coping skills to lessen the effects of the event. Patients should also be up front with their pain care providers about what’s going on in their life so that providers can help them appropriately manage your pain. You don’t need to go into great detail about your divorce or family loss, but let your pain care specialist know that you’re going through some stressful life events and that you’re aware stress and worsening symptoms can go hand in hand.

We want to help you find pain relief, and that involves treating the physical, mental and emotional aspects of your condition. To connect with a provider who will help treat all these aspects and more, reach out to Dr. Cohn and his team today.

The Prevalence of Pediatric Chronic Pain

December 29, 2014January 18, 2016 / Thomas Cohn, MD

Pediatric chronic pain is a growing problem in the United States. According to recent statistics, 1 in 5 children between the ages of 7 and 18 report that they have weekly headaches, and nearly 1 in 10 experience regular abdominal pain. Additionally, 14 percent say they frequently deal with back pain, and four percent are plagued by musculoskeletal pain.

The biggest concern, however, may be that more children are experiencing chronic pain on a regular basis. According to research published in the journal Pediatrics, the number of children admitted to the hospital due to chronic pain rose from 143 in 2004, to 1,188 in 2010 – an increase of 831 percent. With a growing need for pediatric pain treatment, it’s no wonder that more than 30 hospitals nationwide have opened pediatric pain centers of the past few years. These centers provide children with:

Specialized care

Acupuncture sessions

Unique exercise facilities

Sleep specialists

Extensive outpatient therapy treatment

“Kids may be having more pain than in previous generations, but physicians are also more attentive to it and doing more about it,” said Dr. Navil Sethna, clinical director of the rehabilitation center at the Mayo Family Pediatric Pain Rehabilitation Center, one of the top pediatric pain centers in America. Clinics like the Mayo Family Center focus on treating difficult chronic conditions, like fibromyalgia, frequent migraines or ailments resulting from a virus or other injury.

Dr. Lonnie Zektzer, director of the children’s pain and comfort care program at Mattel Children’s Hospital ULCA, said he’s referred children to the Mayo Family Center, and those types of clinics are growing in demand.

“Such programs are becoming more of a trend because they’re so badly needed.”

Pain Management vs. Pain Cure

For many of these facilities, curing the pain is the ultimate goal, but that’s not always possible. Instead, these clinics focus on helping children manage their pain and strengthen their bodies so they experience a gradual reduction in pain over time.

“We teach them how to handle any pain that comes from getting jostled in a hallway or gym class,” said Jenna Duckworth, an occupational therapist who works at the Mayo Family Pediatric Rehabilitation Center.

Judy Gaughan, a nurse and clinical coordinator at the same facility echoed Duckworth’s sentiments, saying, “The treatment goal is to maintain and regain function, not a complete alleviation of pain.”

The center notes that nearly 90 percent of children who finish their program still experience pain symptoms, but the majority report a gradual reduction over several months as they return to normal life.

A 2012 study also shows that the center is improving chronic conditions in children without heavy reliance on painkillers. Nearly all of the 56 children admitted to the program during its first year were taking fewer prescription pain medications 10 months after discharge, the children on meds were usually on a non-addictive preventative drug, and 30 percent weren’t on pain meds at all.

Related source: Boston Globe