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Supporting Children Who Suffer From Chronic Pain

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Chronic pain is something that many children suffer from, and it is not something that is talked publicly about very often. I have supported a good friend of mine who has a child who has suffered from chronic pain for many years, and I have seen how the doctors at CHOC Children’s have helped to support her child and family lead a normal life as much as is possible.

Earlier this month, I met with Dr. Harpreet Kaur, a CHOC Children’s psychologist about pain management in children. There are many causes and effects of pain, and one of the things they see a lot at CHOC Children’s is how chronic pain can impact a child’s overall functioning and participation in their own lives. Dr. Kaur shared that they see a child’s physical and social activities decline. Pain can also affect sleep and family functioning and so when they work with patients, they see the impact not only on the child but on the overall family unit. “It can sometimes be associated with anxiety and depression symptoms, especially when the child does not feel like they can do as much as they used to and that begins to impact their daily functioning and overall identity,” said Dr. Kaur.

A big part of what they do as psychologists at CHOC Children’s is work a lot with parents and caretakers. They encourage parents to validate their child’s pain. Chronic pain can impact children in many ways, and we do not want children to feel invalidated or misunderstood. Dr. Kaur shared that it is essential for parents to encourage normal activities. “Many children who experience chronic pain may not want to go to school or see their friends. While we are validating and acknowledging that the pain is real, we also want them to partake in activities that are essential to a healthy childhood,” she said.

She continued to share that it is important for parents to encourage school attendance, completing responsibilities at home, like their daily chores, and encouraging participation in extracurricular or other preferred activities.

“We really encourage parents to remove the focus off of the pain, while highlighting the child’s abilities and independence. When a child reports that they are in pain, ask them what you can do to help,” she said.

If you are working with a psychologist, Dr. Kaur recommended using some of the skills that you are learning in therapy, such as diaphragmatic breathing, to help manage pain symptoms. Another thing you’ll want to do is reward your child’s participation in school or other activities and understand that it might be tough for your child to complete these activities. She recommended coming up with an age-appropriate rewards system that will be motivating for your child.

Dr. Kaur shared that psychologists are available to support families who may feel stuck because the interventions may not be working. Parents may be following the recommendations provided by their medical team, but their child may still be experiencing pain. In that case, a referral to a psychologist may be helpful for parent support, individual therapy for the child, and brainstorming other potential sources of support for the family.

“There are many skills a psychologist can teach a child. Some of the basic strategies include breathing techniques, progressive muscle relaxation, and relaxation through visual imagery. We can also teach children how to reintegrate into their lives again by coming up with a points system that they can use for activities or by using activity pacing, which is slowly reintegrating children back into and allowing breaks, as necessary. The goal is to increase the time they spend in activities they previously enjoyed,” she said.

At CHOC Children’s, they also work with the parents by providing a list of parent management guidelines including how to improve communication around pain, how to talk to your school about what’s going on and providing letters if you need support in the school.

Sleep is something else that can impact a child who is in chronic pain. Psychologists can make recommendations to assist with sleep problems that often include modifications to the environment and/or behavior.

One thing that parents struggle with is getting the child to understand why a visit to a psychologist could be helpful. Dr. Kaur said, “We don’t want kids to think that they must see a psychologist because the pain is in their head or that the pain isn’t real. We want children to know that we will validate what they are going through, we believe the pain is real and we are here to teach them strategies to help live their best life.”

Chronic pain is real, and it impacts many children in our community. Psychologists are available to help give parents and children the tools needed to try and live as normal as a life as possible while your child is in pain. Learn more about CHOC Children’s online, Facebook, and Twitter.

Book Resources for Parents:
Conquering your Child’s Chronic Pain: A Pediatrician’s Guide for Reclaiming a Normal Childhood, by Lonnie K. Zeltzer and Christina Blackett Schlank
Relieve your Child’s Chronic Pain: A Doctor’s Program for Easing Headaches, Abdominal Pain, Fibromyalgia, Juvenile Rheumatoid Arthritis, and More, by Elliott J Krane and Deborah Mitchell
A Child In Pain: How to Help, What to Do by Leora Kuttner

Listen to our pediatric psychologists as they guide you through scenarios to  help you feel better.
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