Pain in children

DEFINITION

Physical pain is an unpleasant feeling that comes with actual
or potential physical injury, damage or disease. Children are
sometimes too young, too sick or too afraid to say how much pain
they have. To determine how much pain a child is feeling requires
special communication on the part of the parent.

DESCRIPTION

Pain in children may result from any of the following
causes:

Earache as a result of otitis media, glue ear, or dental
problems.
Colic (Infantile) in babies aged up to 6 months.
Headache and migraine, possibly related to stress, allergies or
food intolerance.
Trauma following immunisation, cuts, bruises, bumps, falls or
fractures.
Abdominal pain caused by infections, food intolerance,
ingestion of toxic substances, excess food intake or surgical
problems such as appendicitis.
Pain related to bacterial or viral infections such as sore
throat, aching joints, skin rashes, eye irritation and blocked
nose.
Pain related to chronic diseases such as cancer or
leukaemia.

The best way to assess pain is to ask the child where they
hurt and how much. Measurement of pain in babies, especially sick
babies, is perhaps the most difficult of all. Crying, fussing,
sleeplessness, rapid heart rate and breathing and changes in facial
expressions are an indication of pain.

For older children, try using a doll or teddy and ask the
child to point to where it hurts. Children under 4 years of age can
often tell us that they are hurting. However, they usually cannot
say how much pain they feel. For children over 4-5 years of age,
drawings of pain faces are often best. Children point to a face on
the scale that matches how they feel. Children who are 6 or 7 years
old can rate their pain on a 0-10 scale. Zero is no pain and 10 is
the worst possible pain.

TREATMENT OPTIONS

For most minor pains, comfort, cuddles and a “make it better
kiss” are all that is required. Always consult your Doctor if your
child has pain that cannot be relieved, if the cause is unknown, or
if it recurs.

Drug-free pain relief

Distraction is used to focus the child’s attention away from
the pain. Simple measures such as reading books, blowing bubbles,
playing soft music and counting are good techniques for children.
Touch can be an important distraction technique. Stroking, patting,
bathing and rocking infants can be very effective.
Deep breathing is a good technique to use with young children.
The child is instructed to take a deep breath through the nose and
“blow away their pain” through the mouth.
Muscle relaxation is used to decrease mental and physical
tension. A muscle relaxation exercise can be used with most
children over 5 years of age. Slowly each muscle is tensed and then
relaxed in a systematic way.
Guided imagery involves encouraging the child to imagine they
are in a safe, pleasant place. When imagining a favourite place the
child is asked to feel the warmth all around, see the colours,
smell the odours, and hear the sounds. This helps the child create
a clear scene in their mind. A guided imagery exercise can be used
with school age children and adolescents.

ORGANISATIONS & SUPPORT GROUPS

See the Australian Pain Society topic on the
Healthpoint.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

Ask about the range of non-drug pain relief products.
Ask about specific pain relief medication designed for
children. Paracetamol is a suitable choice.
Avoid giving children aspirin. Aspirin should not be given to
children under 16 years of age unless specified by a Doctor.
If appropriate, make sure your child has daily exercise (if
necessary, after a physical examination and approval by a Doctor).
Walking and swimming are examples of gentle exercise which may help
to reduce pain, particularly in the joints, muscles, ligaments and
tendons of the body.
Consider giving your child a vitamin or mineral supplement if
dietary intake is inadequate. When managing pain the body may
require extra nutrients such as the B group vitamins. Pain
relievers may increase the need for certain necessary
vitamins.

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