Chronic Pain in Children: What’s a Parent to Do?

Mother and little girl blowing bubbles in parkMia was a sweet, blonde, blue-eyed 6-year-old just finishing first grade when I met her. She was a bit shy but full of smiles. She was eager to draw with the markers and paper I had laid out on the table. Mia drew a cheerful, brightly colored rainbow. Initially, there wasn’t a hint of anything wrong. She was just as her parents Emily and Adam had described her when I had met with them the week before. But there was something wrong. Mia had cystic fibrosis, and life had recently become complicated for her and her parents.

Validating Your Child’s Pain Without Catastrophizing

Lately, her parents explained, Mia had been asking repeatedly to stay home from school, saying each time she didn’t feel well. Adam and Emily were dedicated parents, keenly attuned to all their children’s needs. It was already the end of the school year, and Mia had consistently excelled in all her schoolwork. She had three close friends in her class. Her teacher was especially kind. Mia seemed fine to Adam and Emily.

“How can I figure out if she is really not feeling well because of her medical condition, or is she just using this as an excuse to get me to agree to let her stay home from school?” Emily asked.

This is a common dilemma for parents of children with chronic illness, whether the child has cystic fibrosis, asthma, colitis, juvenile rheumatoid arthritis, diabetes, seizure disorder, or one of a whole host of other issues.

As I explained to Emily and Adam, we will never really know if a child is truly in pain. There is no conclusive lab test for chronic pain. There is no way to “prove” your child is feeling well. There can be a very heavy price to pay when, as a parent, you go out on that fragile limb of trying to convince your child they feel well when they say they don’t.

Ultimately, we need to accept what the child says as truth—their truth—and move on. Children with chronic illness fare best when their parents are supportive and calmly validate the challenges and pain they experience without catastrophizing or delegitimizing their experiences.

Was Your Child ‘Faking’ or Just Good at Self-Care?

Chronic pain can ebb and flow. What determines the intensity of pain is a complex a set of factors. Just because your child seems to feel better when watching a favorite TV show doesn’t mean your child was “faking” not feeling well. Actually, kids may be smarter than adults at figuring how to use a key tool in successful pain management: distraction. TV shows, movies, video games, or engaging in social media may be successful pain-management strategies for your child. Therefore, a reprieve in pain by engaging in screen time doesn’t necessarily “prove” your child didn’t feel well in the first place; it may just be proof that your child has identified some successful tools for managing pain and discomfort.

Validating Your Child’s Experience but Disagreeing with the Conclusion

On the other hand, even if you accept that your child doesn’t feel well, it doesn’t mean you have to accept your On the other hand, even if you accept that your child doesn’t feel well, it doesn’t mean you have to accept your child’s conclusion that they shouldn’t go to school.child’s conclusion that they shouldn’t go to school. Parents can still point out the advantages of going to school; for example, “So-and-so is looking forward to playing with you at recess.”

You can create age-appropriate enticements for your child to go to school: perhaps a special treat in their lunchbox or a special activity after school. Of course, there are also times when parents need to remind their child sometimes we need to carry on with our responsibilities (such as going to school or work) even when we don’t feel 100%.

What Else Might Be Going On?

How is your child functioning at home, school, with friends, at after-school activities, sports teams, dance class, or youth groups? Might there be something else bothering your child? Did something troublesome happen on the school bus, in the classroom, or with you?

If your child still insists they don’t want to go to school on the grounds they don’t feel well and you’ve evaluated the entire context for the request, you may come to the conclusion that the advantages of your child missing school that day outweigh the disadvantages.

You Are Your Child’s Security Net

It really boils down to trust. Children who have a chronic illness need to be able to trust their parents when they say they are not feeling well. Your relationship with your child is more important than a missed day of school or even several missed days of school. Open communication between you and your child is the basis for the “teamwork” critical to optimizing your child’s health. As parents, your unconditional support of your child is the very fiber that makes up the security net protecting your child as they face adversity and manage their physical pain.

Pain-Management Techniques You Can Try at Home

  • Educate yourself on pain: This 10-minute video, Understanding Pain – And What’s to Be Done About It, from the German Paediatric Pain Centre, is great for helping older children, adolescents, and parents understand pain and how to manage it.
  • Guide your child in activities that require deep breathing: This might include blowing bubbles (liquid bubbles or with bubble gum), singing, blowing pinwheels, harmonicas, or birthday horns.
  • Laughing induces deep breathing: Watch an age-appropriate comedy show or movie together or read a joke book together.
  • Talking can help regulate breathing: For this activity, the topic doesn’t matter. You can even talk to yourself!
  • Music: Sing, make it, or listen to it to encourage distraction from pain.
  • Exercise: Walking, swimming, or other exercise, if not contraindicated because of your child’s physical condition, can be beneficial for managing pain.
  • Introduce your child to yoga: Yoga for kids, if not contraindicated because of your child’s physical condition, can be beneficial for both fitness and pain management.

Reference:

Langer, S. L., Romano, J. M., Levy, R. L., Walker, L. S., & Whitehead, W. E. (2009). Catastrophizing and parental response to child symptom complaints. Children’s Health Care: Journal of the Association for the Care of Children’s Health, 38(3), 169–184. Retrieved from http://doi.org/10.1080/02739610903038750

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  • tylan

    tylan

    March 23rd, 2016 at 11:03 AM

    It can be hard to know with children, and with some adults too I guess, because when someone talks about something all the time you don’t know whether it is for real or if they are just trying to seek out attention. I think that I know my own children well enough to tell the difference but I do think that maybe I need to pay closer attention to make sure that when they share these things with me I am then in return giving them what they need to process and deal with it.

  • Dan

    Dan

    March 23rd, 2016 at 2:24 PM

    You can’t ignore it. What if it is something serious?

  • Rhea

    Rhea

    March 24th, 2016 at 9:01 AM

    We started my child working with a counselor on EMDR. This has helped us tremendously in handling both her anxiety as well as those feelings of physical pain that were associated with those anxious feelings

  • Kat

    Kat

    March 25th, 2016 at 7:58 AM

    And what about those who just sort of validate everything and then the kid whines about it all the time? How is that helpful?

  • Dawn

    Dawn

    March 26th, 2016 at 5:37 AM

    when a child is suffering it is only natural that the parents will often feel the very same thing

  • Delia

    Delia

    March 28th, 2016 at 3:15 PM

    As a parent you want to do what you can to make them feel better and there will always be those times where sometimes you can help and other times there is not much you can do to soothe them. You will come up with your own little ways, things that will work for you and your family but a lot of times this is only done through a lot of trial and error. But regardless of how long it takes you know you will keep trying because this is your child.

  • Jenn

    Jenn

    March 29th, 2016 at 3:58 PM

    You need to believe in your child and trust that you have raised them where they feel like they can be honest with you.

    I would hate to think that my child was doing this for attention or that they were causing themselves to believe that they were in real physical distress just because they need something that I am not giving to them.

  • Collin

    Collin

    March 30th, 2016 at 4:15 PM

    More often than not you will find that kids take their cues from their parents… so however the parent reacts to something then there is a good chance that they child will react the same way. There are of course some things that you need to make a big deal of and then other things? Not so much. Think about it as an adult and show your children how a true adult should react in any given situation. I think that you will find that your child will very much benefit from this in the long run.

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