Recurrent and Chronic Pediatric Pain

Abstract

Chronic pain is a frequent complaint in childhood and adolescence and is estimated to affect 15 to 20% of children (Goodman & McGrath, 1991). In addition to the suffering this brings, there are significant physical, socioemotional, and financial consequences related to pain and disability for both children and families. Literature on the long-term effects of pain in early childhood raises interesting questions about permanent changes in pain processing and increased sensitization to noxious stimuli that may persist years into the future (Fitzgerald & Howard, 2003). The interface between pain, mood disorders, and broader social and emotional adjustment seems obvious, yet few studies have systematically examined these effects in children (Bursch, Walco, & Zeltzer, 1998). The relationship between pain experiences and chronic pain in childhood and clinical pain problems in adulthood is an area discussed from a theoretical standpoint, but little has been done empirically (Campo et al., 2001; Walco, 2004; Walco & Harkins, 1999). There is a great deal of literature on the fiscal impact of chronic pain in adults (Turk, 2002), and one can only speculate on the financial impact of lost wages and decreases in productivity from work missed to care for a child in pain. Perquin et al. (2000) found that 25% of a sample of children and adolescents aged 0 to 18 years had chronic pain (defined as continuous or recurrent pain for more than 3 months), of whom 57% consulted a physician and 39% used medication for the pain, clearly adding to costs of medical care. In sum, chronic and recurrent pain in children is hardly a trivial concern that children will merely outgrow (McGrath & Finley, 1999).