Pain is an unpleasant feeling that can happen when nerves or tissues are damaged. It is a signal of potential harm to the body. But pain can feel different for each person. It is not something you can see. Pain is based on what your child feels and experiences.
Pain can be acute or chronic:
Acute pain is sudden. It tells the body that something happened that needs attention.
Chronic pain lasts longer, often 12 weeks or more. It may continue even after the original cause of pain has improved.
Types of pain
Tissue-related pain (nociceptive pain): Pain caused by damage to tissues, organs, or bones. It usually feels like an ache, sharp stabbing, or throbbing. It may come and go or be constant.
Nerve pain (neuropathic pain): Pain caused by nerve injury. Some chemotherapy medicines, such as vincristine, can cause this type of pain. It may feel like shooting, burning, or tingling pain. Nerve pain can go away on its own, but it can also be chronic.
Assessing your child's pain
Your care team will work with you to find out:
What is causing the pain
The intensity or severity of the pain
How the pain affects everyday tasks or activities
What the pain feels like
Your care team will ask questions about how pain affects your child’s daily life, such as going to school, playing with friends, and doing favorite activities. Your care team may ask you or your child questions such as:
Does pain interfere with your child’s normal daily activities?
Does pain make it hard to do activities such as reading, playing with friends, watching TV, playing video games, or talking with someone?
Does pain cause your child to limit or avoid physical activity?
How often does your child think about or talk about the pain?
Your care team will measure the intensity of your child’s pain using a pain scale for children. The pain scale will be based on their age and if they are able to rate the pain themselves.
It is important to be honest about pain symptoms. This will help the care team understand causes and plan treatments.
FLACC Pain Scale: For children younger than age 4
The FLACC scale is used for young patients under 4 years of age or for patients who can’t give a pain score. This scale rates behaviors associated with pain. A score of 0, 1, or 2 (0 being the least amount of pain) is given to each of the following 5 categories:
Face
Legs
Activity
Cry
Consolability (ability to be comforted by the caregiver)
The scores for each category are added to give a total score of 0–10.
0: No pain, comfortable
1–3: Mild pain or discomfort
4–6: Moderate pain or discomfort
7–10: Severe pain or discomfort
Faces Pain Scale: For children ages 4–7
The Faces Pain Scale – Revised uses pictures of facial expressions to help young children rate their pain. The faces show how much something hurts.
The faces represent a pain rating from 0 (no pain) to 10 (very much pain). The faces show more and more pain as the numbers go up.
Your child will be asked to point to the face that shows how much they hurt right now.
Pain rating: Children ages 8 and older
Most older children, teens, and adults can rate their pain using a simple 0–10 scale, 0 for no pain and 10 for intense pain.
In addition to a pain score, the doctor will classify the type of pain based on the cause of pain and how your child describes the feeling of pain.
Pain management in children
The goals of any pain management plan are comfort, being able to do daily activities, and overall quality of life.
Your care team will work to prevent and manage your child’s pain as part of routine care. But some cases of pain need special attention. That is when the pain management team may become involved. A pain management team may include different pain specialists. Care team members who treat pain may include:
An accurate, complete assessment of pain is important because it helps your care team develop the best possible pain management plan. Let your care team know:
When the pain started
How often the pain occurs
When pain happens or what causes pain
Where your child feels pain
If the pain is constant or comes and goes
How the pain feels
Words that describe pain may include: aching, burning, cramping, dull, heavy, hot, pins and needles, sharp, shooting, stabbing, tender, tingling.
Your care team may ask you to keep a pain diary or journal. For example, keep track of:
When pain happens
How bad the pain is
What pain feels like
What makes pain worse
What makes pain better
This can help you and your child’s care team to notice any patterns or pain triggers, such as:
The times of day when pain is more likely to occur
After what types of activities (or lack of activity) pain is more likely to happen
Be sure to note any medicines or strategies used to treat pain and how well they worked.
Questions to ask your care team
How will you measure my child’s pain?
How often will you measure my child’s pain?
What do the pain scores mean?
How should I talk to my child about their pain?
What strategies will be used for pain management?
Are there ways to manage pain without medicine?
Who should we contact if my child’s pain gets worse?
Key points about measuring pain in children
Pain is common in children living with a serious illness, but it looks different in each child.
Different pain scales are used at different ages to assess pain in children.
Pain scores are used to plan pain management strategies that fit your child’s needs.
Pain management may include pain medicines and non-medication strategies.
Be honest and open with your care team. If your child is in pain, let your care team know.
— The Together by St. Jude™ online resource does not endorse any branded product or organization mentioned in this article.
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