Study a breakthrough in understanding chronic pain in children

August 23, 2017, University of Calgary
Study a breakthrough in understanding chronic pain in children
Melanie Noel, as assistant professor in the Department of Psychology and a member of the Alberta Children's Hospital Research Institute, studies pediatric pain. Credit: Mike Ridewood, for the Faculty of Arts 

A University of Calgary psychologist who studies pediatric pain has made a breakthrough in understanding the cause of chronic pain in adolescents—by focusing on those recovering from major surgeries.

Melanie Noel, an assistant professor in the Department of Psychology and a member of the Alberta Children's Hospital Research Institute, has found that adolescents' memories of pain following major surgeries influences their recovery and may lead to the development of —which is pain that persists beyond the expected time of healing. Noel published her findings recently in a paper she co-authored in the journal Health Psychology.

Noel and her co-authors assert that psychological and language-based interventions may be used to help adolescents better cope with their post-surgical pain, thus reframing their memories of the pain and potentially altering the path that can lead to chronic pain.

Cause of chronic pain in youth a mystery

The study could have huge implications for the health of Canadian youth, Noel points out, given that 15 to 40 per cent of youth experience chronic pain, a growing public health epidemic (larger in scope than childhood obesity and asthma) that costs the Canadian health-care system $15 billion a year. Studies have also shown that 60 per cent of children with chronic pain will become adults with chronic pain and .

The cause of chronic pain in youth, however, has been nearly impossible to pinpoint. That is, until Noel and her team began to focus on adolescents who were going through major surgeries, such as spinal fusions for scoliosis.

"This is not to say that every child who has chronic pain had a surgery that led to it," stresses Noel. "Rather, it's that surgery is the only context where we can catch these kids before they develop chronic pain. We know that 15 to 20 per cent of children who undergo these major surgeries will develop chronic pain. So, if we can catch them early and begin to understand the factors leading to their chronic pain, maybe we can prevent it from happening in the first place."

The study followed 66 children and their parents from two pediatric hospitals in Seattle. Reports of the children's pain following major surgeries were compiled at one month and then at four to six months post-surgery. The results revealed that the children's memories of the pain they experienced proved to be a strong predictor of pain experienced beyond the expected time of healing.

The way children remember pain is an underlying factor

"We've discovered that the way children are remembering their pain is an underlying factor in the development of chronic pain," Noel explains. "It's not the pain they actually experience so much as the way they process those memories of the pain which is driving whether or not they're improving, right around the time that pain can transition into chronic pain. At a certain point, these children should be feeling better but those who develop chronic pain are not."

She adds: "The pain they're experiencing is real even though the actual expected healing time is over. What happens is the brain takes over and starts sending , even in the absence of injury."

Noel notes that children prone to anxiety are often more likely to develop chronic pain following surgeries. "Some children get hurt and it's 'Aw, that wasn't so bad.' Other kids, two weeks after they get a needle they're still saying 'Oh, that was so awful.' More anxious kids are more likely to develop negative memories over time. We're starting to understand who these kids are."

New knowledge can guide post-surgery interventions

That understanding can help physicians, psychologists and even parents in helping who may be prone to chronic pain change their course post-surgery.

"We can teach kids how to reminisce and talk about their pain experiences in a way that emphasizes anything positive about it," says Noel. "Maybe the child coped with something well, maybe there was a really friendly nurse. It's getting them to talk about things that aren't just focused on the awful after effects of the . It's a way of catching it, a talk-based intervention that can possibly reframe the memories. This may actually alter the pain trajectory. It's one thing we can do to make the recovery and future experiences of better."

Explore further: Post-op pain may often be underrated by inpatient staff

More information: The Influence of Pain Memories on Children's and Adolescents' Post-Surgical Pain Experience: A Longitudinal Dyadic Analysis. Health Psychology. Advance online publication. DOI: 10.1037/hea0000530

Related Stories

Post-op pain may often be underrated by inpatient staff

July 20, 2017
(HealthDay)—Postoperative pain is frequently underrated when assessed by nursing staff on wards, according to a study published online July 14 in PAIN Practice.

Terminology of chronic pain published

February 9, 2016
The Journal of Pain Research has published the commentary "Terminology of chronic pain: the need to "level the playing field".

Lumbopelvic stabilization training therapeutic for LBP

January 5, 2017
(HealthDay)—For patients with chronic nonspecific low back pain conditions, lumbopelvic stabilization training (LPST) has a therapeutic effect on pain modulation, according to a study published online Jan. 2 in Pain Practice.

Chronic pain in parents appears associated with chronic pain in adolescents, young adults

November 19, 2012
Chronic pain in parents appears to be associated with chronic nonspecific pain and chronic multisite pain in adolescents and young adults, according to a study published Online First by Archives of Pediatrics & Adolescent ...

Children suffer unnecessarily from chronic postoperative pain

October 27, 2011
Are children suffering needlessly after surgery? UC Irvine anesthesiologists who specialize in pediatric care believe so.

Pain control in children with cerebral palsy: Treat the cause, not the symptoms

July 15, 2013
Researchers at Holland Bloorview Kids Rehabilitation Hospital have found that more than 25 percent of children with cerebral palsy seen by physicians have moderate to severe chronic pain, limiting their activity. Findings ...

Recommended for you

Novel molecular target to prevent scarring of the lung blood vessels identified

June 13, 2018
Pulmonary arterial hypertension, a severe form of cardiopulmonary disease in which the arteries that transport blood from the heart to the lungs become thickened, constricted, and scarred, is a disease for which there is ...

Fast-acting cholera vaccine could curb outbreaks

June 13, 2018
A tricked-out cholera vaccine starts protecting against the deadly disease within a day, experiments in rabbits suggest. The rapid protection offered by this designer vaccine may one day limit the spread of cholera outbreaks, ...

Lineage of TB traced and compared to early human migration

June 13, 2018
A team of researchers from the University of Wisconsin, the University of Iowa and the Norwegian Institute of Public Health has carried out genetic studies of tuberculosis to learn more about its lineage and to compare it ...

Finally, hope for a syphilis vaccine

June 12, 2018
Despite efforts to eradicate it, syphilis is on the rise. Until now, most health agencies focused on treating infected people and their sex partners but new discoveries may make a vaccine possible, UConn Health researchers ...

How to slow down Ebola—Virologists use 'genetic trees' to evaluate intervention strategies

June 12, 2018
The phylogenetic tree of the 2013-2016 Ebola epidemic doesn't just reveal how the Ebola virus was able to evolve—it also reveals which events and preventive measures accelerated or slowed down its spread. These findings ...

Small children and pregnant women may be underdosed in current malaria regimen

June 12, 2018
Current recommended dosing regimens for the most widely used treatment for uncomplicated Plasmodium falciparum malaria may be sub-optimal for the most vulnerable populations of patients, according to a study published this ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.