At some time in our lives we will all experience pain—physical and/or emotional discomfort caused by illness, injury, or an upsetting event. Though most of us would rather avoid it, pain does serve an actual purpose that is good and seen as “protective.” For example, when you experience pain your brain signals you to stop doing whatever is causing the pain, preventing further harm to your body.Pain, however, is not meant to last for a long time. Pain that typically lasts less than 3 to 6 months is called acute pain, which is the form of pain most of us experience. For some people, pain can be ongoing or go away and then come back, lasting beyond the usual course of 3 to 6 months and negatively affecting a person’s well-being. This is called chronic pain or persistent pain. Put simply, chronic or persistent pain is pain that continues when it should not.Chronic pain is often associated with other health conditions such as anxiety and depression, resulting in a low health-related quality of life. [1]
Living with daily pain is physically and emotionally stressful. Chronic stress is known to change the levels of stress hormones and neurochemicals found within your brain and nervous system; these can affect your mood, thinking and behavior. Disrupting your body’s balance of these chemicals can bring on depression in some people.There are several ways chronic pain associated with these conditions can interfere with your everyday life. It can affect your ability to function at home and work. You may find it difficult to participate in social activities and hobbies, which could lead to decreased self-esteem. It is also common for people with chronic pain to have sleep disturbances, fatigue, trouble concentrating, decreased appetite, and mood changes. These negative changes in your lifestyle can increase your pain and dampen your overall mood; the frustration of dealing with this can result in depression and anxiety.
Numerous behaviour change interventions have been developed for individuals with persistent pain. Although they have their own rationale and principles, they result in comparable (positive) outcomes, possibly by influencing what individuals think, how they think and what they do [8]. These factors reciprocally influence each other, so that even though one intervention targets one specific factor, the influence on this one will likely produce changes in the other ones as well. Changes in all these three variables could then influence pain-related outcomes and explain the similarity of findings with somewhat different interventions. Behaviour change interventions can be used in individual treatments or in group settings where peer models and vicarious learning and social persuasion can be incorporated.
The evidence for behaviour change interventions is mixed and can sometimes be difficult to compare across studies due to the use of different outcomes (e.g., reduction in pain intensity, increased activity). Nevertheless, a Cochrane review of behaviour change interventions in adults with persistent pain [14] reported small or very small effects of CBT on pain, disability, and distress; and no evidence of behavioural therapy and acceptance and commitment therapy as compared to active control or treatment as usual interventions.
In children and adolescents, the evidence is more spars. A recent update of a Cochrane systematic review [5] reported that some behaviour change interventions, such as psychological treatments, seem effective for reducing pain in headache and mixed persistent pain conditions at post-treatment, and to reduce disability in mixed persistent pain conditions at post-treatment and follow-up, and for headaches at follow-up.
Children struggling with chronic pain are at a higher risk of developing mental illness. Be aware of this risk and get your child treatment when you see that they are not coping. Not doing so can affect both their physical and emotional well-being.It’s difficult for anyone to live with chronic pain, but it may be even more so for children. They often don’t understand why they have the pain, or the best ways to go about trying to address it. All they know is that they hurt, and they usually turn to the adults in their lives for relief. Many parents and caregivers want to help, but they simply don’t know what they should be doing to make things better, or at least not make the situation worse.
Using psychological interventions is one way that parents can help children who have chronic pain. There have been numerous studies published over the years on the issue, looking at the various ways that parents can help the situation.