Many medical conditions cause pain. Think about having the flu, an ear infection, or spraining an ankle. Pain is a message that lets people know that something is wrong and needs attention. Pain is a common symptom.

Most pain is temporary, fading away as the problem is fixed. Occasionally, pain outlives its purpose and becomes "useless pain". This type of pain takes on a life of its own and can be very debilitating. The reason for this is not always known, but there are things that can help.

Signs and Symptoms of Medical Pain

Children describe their pain in many ways. Words such as achy, sharp, dull, electrical, burning, throbbing, pressure or stabbing can help your child's doctor find the right medicine for your child's pain.

Infants and nonverbal children sometimes appear irritable, have difficulty sleeping, or have a decreased appetite when experiencing pain.

Treatment for Medical Pain

The treatment of pain includes many therapies based on the cause. Mild pain is often managed with single therapies. Severe and complex pain requires combined therapies including medication, physical therapy, psychology and relaxation training. Treatments include:

• Some pain, like for arthritis, is due to inflammation. An anti-inflammatory medication would be useful to treat this type of pain.
• Nerve injury can bring a different type of pain, which will respond to medicine designed to calm misfiring nerves.
• Pain is made worse by depression and tension, so relaxation training, massage and healing touch can be helpful.
• Biofeedback, acupuncture and TENS units are other ways to treat pain.
• Biofeedback training teaches children techniques that can improve health and performance by using signals from their own bodies to help control heart rate, blood pressure, temperature and muscle tension
• Acupuncture is the procedure of inserting and manipulating needles into various points on the body to relieve pain or for other therapeutic purposes
• "TENS" stands for transcutaneous electrical nerve stimulation. This is a palm-sized device that uses a small amount of electrical current to help the body shut down incoming pain messages at the level of the spinal cord. It can be useful for localized pain (pain in a specific area) and has few side effects.

At Cincinnati Children's Hospital Medical Center, we offer a wide variety of pain therapies. These include medicines and high-tech therapies, as well as humanistic and integrative health. Your child's doctors and nurses will work with you to find the combination that is right for your child. For severe or complicated pain conditions, your child's doctor may consult with the Pain Management Service at Cincinnati Children's.

Your primary pediatrician or family physician can handle most of the common types of pain. If basic evaluation and treatments have not helped, your child's primary doctor may refer you to a specialist. For example, an orthopaedic surgeon will have options for the best care of a broken bone or sprained ankle. A hematologist will help manage sickle cell disease pain. Gastroenterologists can help evaluate abdominal pain.

Pain Clinics

Sometimes, pain lasts beyond the expected time course, even after the healing is done. Tests may be negative and you and your doctors may become frustrated. Why would there be so much pain, but nothing shows up on tests?

The answer is not always clear. If headaches are the problem, your child may get a referral to Cincinnati Children's Headache Center. The Pain Management Clinic is another available resource. Both centers utilize a multidisciplinary approach to address the complex nature of chronically painful conditions.

For children with chronic illness or terminal illness, pain management is a vital part of the plan. You should feel free to discuss how your child's pain will be managed over the long term. There are two options for providing this type of long-term help:

1. The PACT (Palliative and Comfort Care Team) is a service available for children and their parents at Cincinnati Children’s. PACT partners with families to offer a range of comprehensive, family-centered care for children with chronic, complex or life-threatening conditions. PACT helps coordinate the child’s medical care along with the child’s present medical care team, supports and teaches pain / symptom management, and assists in making complex medical decisions. Services also available are counseling for sibling concerns and family dynamics, school and social interactions, spiritual concern, and hospice and home health care. PACT referrals can be made by healthcare professionals and parents; contact with family will be made the day the referral is made. A PACT team member can be reached by calling 513-636-5479.

2. StarShine Hospice at Cincinnati Children's is a home-based service that can provide many levels of care for both family and child if a disease or condition is not curable. The program involves a multidisciplinary group of physicians, nurses, child life specialists, clergy and social workers. The program takes a holistic approach to managing comfort by addressing the physical, spiritual and social / emotional needs of the entire family.

   StarShine can provide a positive force when all else looks bleak. Pain care is provided by either the primary physician or by a physician from the Division of Pain Management. A hospice nurse and a pain physician are available 24 hours a day to help with problems or concerns.