aches and how she solves other problems in her life. Gender differences can affect pain perception and how kids cope, too, says McGrath. Girls typically feel freer to talk about their pain, while boys will mini- mize it and are likely to blame their discomfort on a sports injury, if they talk about it at all.
Mix it up A better understanding of and greater insight into
children’s pain means that more physicians are real- izing there’s no one-size-fits-all approach to treating it, and more are giving up the untrue idea that pain is either physical or psychological. That’s good news, which translates into more and better options. For starters, it’s now a lot easier to find an in- or out- patient pediatric pain clinic that takes a multidisci- plinary approach to treatment by offering a wide variety of therapies, such as biofeedback, hypno- therapy, music and dance therapy, acupuncture, massage and cognitive behavioral therapy. Nineteen- year-old Haley Esparza, of Orange County, California, uses a combination of hypnotherapy and yoga to keep the tenderness and fatigue of her fibromyalgia under control. “I learned some great relaxation techniques that have given me a real sense of power that helps me to be in more control of the pain,” she says. “When I can’t fall asleep or I hurt, I’ve done these things with my hypnotherapist enough that I can do them on my own and they work. It’s really awesome.” Georgia Huston felt better right after she first met
with Lonnie Zeltzer for a comprehensive evaluation at UCLA. Why? Among the first things the doctor told her was that she believed Huston’s pain was real. After that crucial validation Zeltzer offered a variety of possible remedies. “I was very skeptical at first because they talked about all these hippie-sounding kind of treatments,” says Huston, laughing. “They told me about acupuncture, hypnotherapy and Iyen- gar yoga, and all these other things no other doctor had ever suggested.” Huston decided to try them. Not every treatment was effective–talk therapy didn’t do much for her and art therapy was fun but not helpful—but hypnotherapy and yoga worked won- ders, she says. Amazingly, much of her back and leg pain went away within a few months of starting regular hypnotherapy sessions. “The mind definite- ly influences how you feel,” Huston says. “If I’m al- ways going to have to live with this pain at least now I have techniques that will help me manage it.” Unfortunately, not everyone has caught on to the
benefits of a multidisciplinary approach to treating kids’ pain. “If only we could get the insurance com- panies to back this kind of all-encompassing treat- ment, we would be home free,” says Michael Stanton-
Five Things You Can Do
If only a kiss on the boo-boo could make it all better. But parents of a child in pain know that helping is often more complicated than that—and sometimes you may feel like you can’t help at all. But don’t underestimate your role: Pediatric pain experts stress that moms and dads are vital to a child’s ability to manage and even end pain. Here are a handful of ways you can help, whether your child’s pain is new or has been going for years.
Act early—but don’t overreact. Think of pain like a snowball rolling down a hill, says UCLA’s Lonnie Zeltzer. The farther it rolls, the more snow and debris it picks up along the way. Similarly, treatment for pain can get more complicated if you wait to get it diagnosed and treated. “Parents should believe their children when they have pain,” says McGrath. “But they don’t have to go into a flurry of activity, or relieve a child of responsibility for duties and chores. Balance is key.” Delaying treatment can add to a kid’s stress, which can make the ache worse, so call the doctor if the pain is severe, if it’s new pain, symptoms or side effects, or if it is lingering for a couple of days. Recognize the need for distance. In cases where a child is experiencing severe, chronic pain, Michael Stanton-Hicks of the Cleveland Clinic may separate child and parents while he’s treating the child if he suspects Pain-Associated Disability Syndrome (PADS). If a family is dealing with PADS, “Parents are often the biggest part of the problem. Enmeshment is the term psychologists use when a father or mother are enmeshed with a child’s pain,” he explains. “In other words, the child, by proxy, becomes a source of maintaining the pain. If the parent is stuck to the child day and night, the child doesn’t have the ability to develop their own self-esteem.” Successful treatment for a child must include a parent’s commitment to breaking the cycle of enmeshment. Look for signs of pain. A lot of kids won’t complain about their pain, notes Stanton-Hicks. “They don’t want to be perceived as weak or weird by their peers.” It’s a reasonable fear in some cases: Ashley Goodall says she lost friends because they thought she was faking. “When I’m not feeling well around new people they think I’m stuck up, because I don’t say much,” she says. Pay attention to how your child is behaving: Does she hold back from physical activities? Does he have trouble sleeping or appear exhausted? Does he seem distracted or very forgetful? Does he find excuses to avoid school and spend time with his peers? These are all possible signs your child is suffering more than you may realize. Go to school. Anticipate challenges at your child’s school, especially if they have an illness that isn’t visible. While schools usually understand the need to accommodate a child with cancer or diabetes, “chronic pain issues like headaches and backaches are harder to see,” McGrath says, “and they can come and go, so they may not take your child’s condition as seriously.” Make an appointment to talk to your child’s teacher and the school nurse, and the principal. And don’t be afraid to repeat yourself. Encourage the good days. There will, of course, be ups and downs for any kid living with chronic pain. When things are going well make sure to prompt your child to spend time with his friends, go to sleep-overs or join activities he enjoys. “We don’t want parents to give up their expectations for their children,” stresses McGrath. “Don’t baby them. Give them the opportunity to do things and contribute to the family on those good days. A warm, support- ive environment with reasonably high expectations is always good for kids.”