Chronic Pain in children

By Steve Dechan

Chronic pain is currently defined as any pain that persists or recurs for longer than three months. Whilst traditionally an issue among adults across the world, chronic pain in children is becoming a significant public health problem and a leading cause of morbidity in children globally.

The quality of life for children and teens with chronic pain is seriously compromised without access to all-important pain control. Compared to their peers, children with chronic pain report higher levels of physical disability, anxiety, depression, sleep problems, and poor academic performance.

Fortunately, the World Health Organisation (WHO) has released guidelines on the management of chronic pain in children, with recommended physical, psychological and pharmacological interventions for pain relief in children aged 0-19 years. These guidelines represent a step in the right direction and support the drive of WHO member states and their partners to develop and implement national and local policies, regulations, pain management protocols and best practices for pain relief.

Chronic pain doesn’t stop at border control, it is an international issue, and should be treated that way.

Little is currently known about the global burden of children’s chronic pain. Available reports indicate that it is encountered by approximately one-quarter to one-third of children; and it is also a sign of long-term disorders such as cancer, sickle cell disease, diabetes, and arthritic conditions.

Access to the highest attainable standard of health and the appropriate high-quality treatments to accomplish this should be a fundamental right of children and adolescents. To achieve this, child- and family-centred services for chronic pain must be available to all.

The recent WHO guidelines are designed to highlight the importance of opioid stewardship in addressing worldwide concerns about opioid use and misuse. Opioid stewardship refers to a series of strategies and interventions involving the appropriate procurement, storage, prescribing and use of opioids, as well as the disposal of unused opioids when opioids are appropriately prescribed for the treatment and management of specific medical conditions.

I am extremely passionate about the issues surrounding opioid misuse and the subsequent addiction that is caused as a result. The emerging prevalence of chronic pain in children provides another setting for opioid addiction to develop and this must be stopped at all costs. I applaud the WHOs attempts at quelling the potential onset of addiction through physical therapy, psychological therapy, and pharmacological management, and I firmly believe this strategy, alongside other key pain-relieving strategies, should be prioritised across the world. We have the potential to stop future opioid crises from emerging and this can be seen as a crucial first step.

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