Shocking New Study: 20% of Children Have Chronic Pain

?A recent study published in the journal Pain concluded that 20% of children under the age of 19 have chronic pain . The study, a meta-analysis of 119 studies across 70 countries, included over 1 million children. Seven of the studies were from the United States. The studies examined spanned the years 2009 to 2023. Most of the studies looked at one type of pain, including headache, abdominal pain, musculoskeletal pain, back pain, and multisite/general pain. What’s most shocking about this study is that most of us generally think of chronic pain as something that tends to happen as people age, as people tend to accumulate more injuries and stress over time and their bodies are less able to repair the damage. The high prevalence of?pain in children is a whole other matter.

This is a serious issue, as pain in children not only causes misery but also has a significant impact on school attendance, academic achievement, socialization and participation in family life. Our healthcare system does a poor job of treating pain, with many treatments, including opioids, creating risk of significant harm, and few resulting in resolution of the problem. This often means that the child will face challenges as an adult entering the workforce and maintaining employment.

An important question is, why do so many children have chronic pain and what should be done to address it. This study does not attempt to address that; however, I have some ideas, at least as it applies to American children. I am not familiar with the conditions in other countries in the study, which include European, Asian, African, Middle Eastern and Latin American countries, as well as Australia and New Zealand.

?Factors that contribute to chronic pain in children in the U.S. are very ? ? similar to those that promote chronic pain in adults:

1. Poor Diet: The diet consumed by a large percentage of American children is abysmal. A?balanced diet is essential for overall health and development, and its impact on chronic pain is substantial. Diets high in processed foods, sugar, and unhealthy fats can lead to inflammation, which can exacerbate pain conditions. In addition, nutritional deficiencies, particularly in vitamins and minerals such as vitamin D, magnesium, and omega-3 fatty acids, can also play a role in chronic pain development.

1. Lack of Exercise:?Most?American children spend way too much time on their phones and computers and too little time exercising.?Physical activity is vital for maintaining muscle strength, flexibility, and overall health. Sedentary lifestyles can lead to muscle weakness, reduced flexibility, and increased sensitivity to pain. Regular exercise helps in the release of endorphins, which are natural painkillers produced by the body. Children who do not engage in regular physical activity are more prone to experiencing chronic pain.
2. Poor Sleep:?Most American children do not get enough sleep.? Factors that contribute to this, especially for adolescents, are too much homework and school days that start too early. Stress also contributes to difficulties with sleep. Sleep is crucial for healing and restoring the body. Poor sleep patterns or sleep disorders can significantly contribute to ?chronic pain. Lack of adequate sleep can heighten pain sensitivity, reduce pain threshold, and impair the body's ability to cope with pain. Ensuring good?sleep habits and addressing any sleep-related issues are essential steps in managing chronic pain.
3. Stress: Psychological stress can manifest physically and contribute to chronic pain. Stress triggers the release of cortisol, a hormone that in excess can lead to inflammation and increased pain perception. Stress also causes increased muscle tension, reduced circulation to extremities, suppressed digestion and suppressed immunity, all of which can contribute to the development of chronic pain. Children under constant stress, whether from academic pressure, bullying or family dynamics, may experience heightened and prolonged pain. Children today also have to cope with fears about climate change, mass shootings and political divisiveness, not to mention the lingering destabilizing effects of the COVID lockdown.
4. Trauma: Both physical and emotional trauma can be significant contributors to chronic pain. Physical injuries that do not heal properly or leave residual damage can cause long-term pain issues. Emotional trauma, such as abuse or significant life changes, can lead to conditions like somatic symptom disorder, where psychological distress manifests as physical pain.

Effective Therapies for Managing Chronic Pain in Children

Addressing chronic pain in children requires a multifaceted approach, combining medical, psychological, and lifestyle interventions. Here are some effective therapies that get to the root of the problem:

1. Exercise and Physical Therapy: Getting children outside and moving, such as walking, bicycling and swimming, can help substantially. Physical therapists can prescribe tailored exercise programs that help strengthen muscles, improve flexibility, and reduce pain.
2. Nutritional Counseling: Working with a nutritionist to develop a balanced diet plan can address nutrient deficiencies and reduce inflammation. Incorporating anti-inflammatory foods such as fruits, vegetables, and omega-3-rich fish can be particularly beneficial.
3. Sleep Interventions:?Establishing a consistent sleep routine, creating a restful sleep environment, and limiting screen time before bed can improve sleep quality. Addressing underlying sleep disorders such as sleep apnea or insomnia through appropriate treatments can significantly impact pain levels.
4. Mind-Body Techniques

• Cognitive-Behavioral Therapy (CBT) CBT is highly effective in helping children manage chronic pain by changing the way they perceive and respond to pain. It can help them develop coping strategies, reduce stress, and improve their overall mental health.
• Mindfulness and Meditation: Practices such as?mindfulness and meditation promote relaxation to help reduce stress and improve pain management.
• Yoga and Tai Chi: These gentle forms of exercise combine physical movement with relaxation techniques, which can be very effective in managing chronic pain.
• Support Groups and Counseling: Support groups can provide children and their families with a sense of community and shared experience. Counseling can help address emotional and psychological aspects of chronic pain, providing tools for coping and resilience.
• Energy Psychology Techniques:?These powerful techniques, that involve focusing on the trauma or fear while tapping or holding acupuncture points on the face, hands and body, calm the nervous system and reduce the emotional charge associated with the distressing event that is driving the pain.
• Biofeedback:?Biofeedback uses sensitive electronic instruments to measure physiology, including muscle tension, blood flow, respiration rate, heart rate and brain electrical activity, and feeds that information back to the patient so that control of physiology and symptom reduction can be achieved. Often paired with training in relaxation techniques.

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Children can also benefit from the many therapies that help adults with chronic pain, including acupuncture , chiropractic , massage therapy , red/infrared light therapy , pulsed electromagnetic frequency (PEMF) therapy, herbal therapies, homeopathy and more. Pharmaceuticals, including opioids and over the counter medications such as NSAIDS and acetaminophen, should be used with extreme caution because of the dangers of side effects with long term use.

Conclusion

Chronic pain in children is a multifaceted issue influenced by various factors including diet, exercise, sleep, stress, and trauma. Addressing these contributing factors through a combination of exercise, physical therapy, nutritional counseling, sleep interventions, mind-body techniques, support groups and adjunctive therapies can provide significant relief and improve the quality of life for affected children. By adopting a holistic approach, we can better support children in managing chronic pain and lead them towards a healthier, happier future.

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