Ouch! Looking into pain in children and teens

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By Lorie A. Parch

Though it’s bad enough that so many adults endure daily discomfort, there’s now solid evidence that more children and adolescents suffer many of the same aches. The July issue of the journal Pediatrics, published by the American Academy of Pediatrics, includes two new studies that help clarify how big the problem of chronic pain is in children and teens.

The first study, led by Dr. Thomas A. Coffelt of the department of pediatrics at Indiana University School of Medicine, in Indianapolis, looked at the rate of hospital admissions among 3,752 kids and teens with chronic pain over seven years in pediatric hospitals nationwide.

Dr. Coffelt and his colleagues found something shocking in crunching data from 2004 to 2010: Hospital admissions for kids with chronic pain rose 831 percent during that period. The most common reason for admission was stomach pain. Patients tended to have other medical problems, gastrointestinal issues in particular. But they also often had psychiatric issues, including depression and anxiety. Girls were much more likely to be admitted than boys, and the kids dealing with chronic pain were far likelier to be back in the hospital within a year and to stay significantly longer (a mean of 7.32 days, versus an expected stay of 4.24 days).

Why the big increase? That’s not easy to answer, Coffelt said in an interview with LiveScience.com. According to the American Pain Society’s position statement on kids and chronic pain, conservative global estimates say that 20% to 35% of those under 18 are affected by chronic pain. They’re most likely to complain of musculoskeletal and stomach pain and headaches. The reasons are likely a combination of physical (including those related to their development) and psychological issues, but for now too little is known about the cause.

The second report in Pediatrics covers research in Taiwan that studied 13- and 14-year-olds and the incidence and causes of chronic daily headache (CDH). (CDH is defined as having a headache 15 or more days every month for more than three months; it includes chronic migraine, chronic tension headaches, and other headache subtypes.) The study authors note that the U.S. adult rate of CDH is 3 percent but that the rate in those under 18 is unknown, so this research helped shed some light on how many adolescents are affected: It found that the incidence rate of CDH among these teenagers was just over 1 percent in a given year. A 2011 Canadian review of studies published in the journal Pain found that headache was the most common type of pain among kids, followed by back pain, musculoskeletal pain, and “multiple” and “other” pains. Girls were more likely to be affected, as were children living in poverty, and the authors called chronic pain that’s not associated with a disease “very common” in childhood and adolescence.

The Taiwan study will help health experts assess the problem of daily headache among kids, but it also helped shed light on what puts a child or teen at risk. As with the Indiana University study and the 2011 review, the Taiwanese researchers found that being a girl raised a child’s risk, as did being in a family with financial problems and obesity.

Since a child with pain very often becomes an adult with pain, it’s essential that researchers continue to not only study the problem but create solutions to lower these rates.

Did you have pain when you were younger? What do you think should be done to stop the rising rates of chronic pain among kids and teens?


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