Tame The Pain

Last week we talked about what it meant to have a chronic illness.

As a chronic illness, Juvenile Arthritis can take many forms, and have a wide variety of symptoms, but one of the things that most manifestations have in common is chronic pain. As a parent, watching my child suffer with chronic, debilitating pain has been one of the hardest parts of coping with this disease. Feeling helpless to fix it runs a close second. It is disheartening for all those involved, but don’t despair!  There are some things that you can do to help alleviate your child’s pain in addition to their medical regimen. Remember that everyone responds differently, and what works for one, may not be as effective for another. I would encourage you to approach these suggestions with an open mind, and if you have any questions PLEASE consult your healthcare professional!

Now that we have that out of the way, lets talk about pain in general.

Pain can be defined as any type of discomfort, but there are different kinds of pain, and they need to be addressed differently.

According to the Cleveland Clinic, acute pain is the type that is suffered after an injury, surgery, or other circumstance and is usually sharp or sudden.  This is also the type of pain that most of us are used to handling with our children: the scrapes, cuts, bumps and bruises that we treat and then wait for them to go away.

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Chronic pain, on the other hand, can range from mild to sharp, cyclical to constant or nagging to predominant. It can be either a result of an injury that has not resolved, a chronic condition that does not go away, and/or pain signals that are not being properly transmitted. In addition, some chronic pain can also be referred pain. That is, pain from one area of the body (that has been ignored or unresolved) causes the brain to send a pain signal to a different, unaffected area in order to be recognized.  Referred pain is often suffered in the form of headaches, stomachaches, muscle fatigue or increased pain radiating beyond the offending area. Every time your child visits the rheumatologist or other specialist, they may be asked to rate their chronic pain based on a scale like the one below.

painscale

 

 

Chronic pain of any type is much trickier to treat on your own, but here are a few of the things we have found that work:

 

1)   SLEEP- Make sure your child is getting quality rest. It is a well-documented fact that decreased sleep can negatively affect pain. If your child is unable to sleep well on a consistent basis, let your healthcare provider know, and help troubleshoot the cause and solution.

2)   DIET- Eat healthy.  I’m not advocating any special pain reduction diet here, just common sense. If you provide your child with quality nutrients and nourishment, chances are better that you will also provide his/her body what it needs to begin the healing process on its own. A healthy diet is one factor that can serve as a springboard to better health, and better health can result in less chronic illness and pain. Simple, but true.

3)   EXERCISE- Although this seems counterintuitive, moderate to low impact activity can help with chronic pain by increasing blood flow and releasing endorphins. Swimming in a warm pool, gentle stretching or yoga are good choices for the child that cannot tolerate much activity.

4)   DISTRACTION- Finding a way to mentally escape from the pain can reduce the level of discomfort your child is experiencing. Spending time with friends or participating in an out of the ordinary activity (like playing a new video game or going to the movies) can draw focus away from the pain and provide some relief.

5)   TRACK PAIN LEVELS- Using a journal to record pain levels and circumstances may provide valuable insight for both you and your child’s physician. Keeping a record can help to identify cycles and triggers that can be adjusted for or altered without major changes to medications or lifestyle. However, avoid frequently asking your child about their pain when tracking symptoms and pain levels, this may inadvertently focus their thoughts ON the pain and make it worse (see DISTRACTION above).

6)   UTILIZE SOOTHING PRACTICES- Find what works for your child to calm and soothe them. Does a warm bath always do the trick? A spray of lavender on their pillow? Warm milk or hot tea before bed? Creating calming, relaxing rituals and routines can also help to calm the parasympathetic nervous system, which is essential for healing. Other ways to engage the parasympathetic nervous system include learning to use biofeedback, meditation, deep breathing, massage and hypnotherapy.

7)   FIND SUPPORT- Helping your child find and interact with other kids in the same situation can be very helpful in managing their chronic pain. Knowing there are others out there that truly understand what they are going through can make a tremendous difference in their mental health and attitude, which can ultimately affect their pain levels. Pain levels and fatigue are generally higher in people showing signs of depression, so providing an outlet where they can be heard, understood and not judged can be extremely beneficial.

In addition to these things which you can do at home, I would strongly recommend a visit to pain clinic if your child frequently experiences high levels of chronic pain. Finding the right fit is very important, as treatment philosophies and modalities can vary from doctor to doctor. Reputable pain clinics are not “pill mills,” and some, like the one we see through UCLA are specifically for pediatric patients! These clinics can often provide access to additional treatments not typically explored through a general physician such as acupuncture, electronic stimulation, use of TENS units, psychological counseling and specific courses of medication, that may provide another pathway to relief for your child.

Most importantly, recognize that the pain your child feels is real.  Whether the pain is acute or chronic, physical or psychological, referred or specific, it all hurts! While you may  not be able to take away 100% of the pain your child feels, exploring some or all of these avenues is a great start to reducing your child’s suffering and providing them with more hope for pain-free days ahead.

 

For more information on managing pain, order Living With Juvenile Arthritis: A Parent’s Guide

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Comments:

  1. Did I ever show you “the other” pain scales? I passed this around the infusion room. The nurses and our doctors were hysterical!

    Sorry. I had to share. :p

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  3. My 15 year old son has recently been diagnosed with Juvenile Spondyloartropy. I’m overwhelmed and looking for support.

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