Most children, if they fall over, maybe break a limb or bark themselves are quite able to express pain. So they’ll cry, they’ll scream, they’ll tell you that it’s hurting. It’s a little different when you get to more long term childhood pain.
So for example, if you’ve got a child who can’t talk yet, but who might have fallen over and got a minor fracture, but not something that’s obvious, you’ll often find that they stop using that limb. So that’s one way that children can tell you about pain, particularly in an upper or lower limb. That tends to go for children who have long term pain in the upper or lower limb as well. You’ll often find that stopping using that limb becomes a major feature, and stops them engaging in all sorts of normal activities.
One of the other longer term pain problems that children can get is abdominal pain. And that can stop them participating in other type of ways. So you might find a child who doesn’t want to go to daycare, doesn’t want to go to school and complains of tummy pain. And so for those children, what you need to do is to start re engaging them with normal activity as much as possible. And we tend to screen them and see if there’s any anxiety or depressive type symptoms as well. Those sorts of things, those sorts of pains can be an indicator that there’s something like that going on in the background, and they need to be treated as part of the treatment of the pain problem.
So even for limb pain, abdominal pain, ongoing headaches, a big part of treatment for children with longer term pain is just reestablishing these normal routines as much as possible, supporting the child and the parents or caregivers within these paediatric chronic pain clinics, working along with the GPs.
Dr Jennifer Stevens is a Pain Specialist at St Vincent’s Hospital, Sydney and Pain Australia