Adolescent Patients With Chronic Pain Different From Adults, Children

LAS VEGAS — Adolescence is defined as the period between 10 and 19 years of age,1 and many individuals in this age group are reported to be living with chronic pain.2 

Despite the prevalence of chronic pain in adolescence, many healthcare professionals do not differentiate adolescents experiencing chronic pain from other age groups when it comes to treatment, and this does not serve the adolescent population well, according to Melissa E. A. Geraghty, PsyD, a health therapist in private practice from Naperville, Illinois. 

It is Dr. Geraghty's opinion that such limitations often diminish the difficulties and capabilities of the adolescent in chronic pain, “making medical and psychotherapeutic interventions that are empirically sound more difficult to find and consequently implement.” 

It is also important to note that many adults with chronic pain first experience unceasing pain as an adolescent or child.

Although there is only limited evidence to support the claim, self-management behaviors related to chronic illness are likely established in adolescence, making psychoeducation and proper medical interventions imperative at the time of presentation, according to Dr. Geraghty.4 How adolescents approach their chronic pain condition at their current age has an effect on how they will experience their condition in adulthood.

Research on chronic pain often focuses on pediatric or adult populations and does not provide insight on how to implement evidence-based treatment for adolescents with chronic pain. This lack of research creates a treatment challenge, she said, because adolescence itself is a diverse age group due to differences in biology, psychological functioning, social interactions, and spirituality. 

During her discussion, Dr. Geraghty explored the effects of chronic pain on an adolescent's life, including adverse effects on neural and cognitive processes, puberty, gender, sleep, and fatigue. 

She said treating adolescent patients must encompass several components, including psychological and social. Psychological components include the grief cycle, cognitive processes, comorbid diagnoses, fear avoidance, physical trauma, body image, and substance use and abuse. Social components include peer groups, familial support, absenteeism, and cultural factors. 

Another important component to consider in the management of the adolescent with pain is their spirituality, including their spiritual pain and uncertainty, as well as their spiritual community. Awareness of this aspect of an individual's personality can assist the healthcare provider in guiding the patient to find meaning in his or her suffering.

References

  1. World Health Organization. Adolescent health and development. Available at: http://www.who.int/maternal_child_adolescent/topics/adolescence/dev/en/. Accessed August 14, 2015.
  2. King S, Chambers CT, Huquet A, et al. The epidemiology of chronic pain in children and adolescent revisited:  a systematic review. Pain. 2011;152(12):2729-2738.
  3. Eccleston C, Jordan AL, Crombez G. The impact of chronic pain on adolescents: A review of previously used measures. J Pediatr Psychol. 2006;31(7):684-697.
  4. Santrock JW. Child Development. 11th ed. New York, NY: McGraw-Hill; 2007.
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