Treating Pain in Children

It is well accepted that both behaviorally and biologically, children are not simply “little adults.” According to the Centers for Disease Control (CDC), children breathe more air per pound of weight than adults, have less fluid in their bodies, and thinner skin (, n.d.). Children may have more difficulties explaining their experience of pain, and as a result, may feel less sense of control when they are hurt (, n.d.). Compounding the problem is the fact that most pain medications are formulated for adults, which makes treating chronic pain conditions such as migraine more challenging (Hershey & Babineau, 2019). All of this points towards integrative approaches that include both pharmacological and behavioral strategies as being particularly relevant in treating this age group.

Three areas of lifestyle are especially important: sleep, diet and exercise. According to the CDC, about 70% of adolescents do not get 8-10 hours of sleep per day, which is recommended for this age group (Hershey & Babineau, 2019). Migraine headache is prevalent in teenagers: up to 4.1% in males and 6.3% in females according to the American Migraine Prevalence and Prevention Study (AMPP) (Cleves-Bayon & Rothner, 2014). Experts suggest that improving sleep quality can reduce migraine frequency (Hershey & Babineau, 2019). In particular, obstructive sleep apnea (OSA) has been associated with migraine, so if the individual exhibits any symptoms (e.g., snoring), it may be worth consulting a specialist.

It is not unusual for adolescents to skip meals or simply not eat enough, especially if they are active. Particularly teenage girls who aspire to be abnormally thin may use this as a dieting strategy. Just as certain foods can trigger headaches, so can not eating enough or not eating regular meals. Parents can play an important role here by encouraging a healthy diet with adequate intake of fruits, vegetables and protein, as well as addressing the weight issue. Hydration is equally important. Many people forget that water is an essential nutrient. Children and adolescents who participate in outdoor sports during the warm weather may need more than the recommended 6-8, eight-ounce cups of water per day.

Finally, it is important for children of all ages to get plenty of exercise. Exercise does not necessarily equate to organized sports. The American College of Sports Medicine (ACSM) recommends that all children and adolescents get a minimum of 60 minutes of physical activity per day, typically a mix of moderate and vigorous activity. In addition to team sports, age-appropriate activities including active play, running, walking, bicycling, dancing and swimming are all good options (, n.d.).

Just as emotions contribute to the pain experience in adults, the same applies to children and adolescents. Kids who are well-rested, who eat well, and have supportive circles of teachers, coaches, friends and family will be better able to cope with the emotional highs and lows of daily living, in ways that do not manifest as physical pain. This is not a suggestion to avoid the family physician when kids are experiencing pain. Rather, consider the above recommendations as tools to utilize in helping them lead healthier, more fulfilling lives.

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