Chronic pain is usually associated with adults and those suffering from serious injury. However, chronic pain in childhood occurs more commonly than one might think. Migraines, stomach aches, back pain and other pain conditions often pop up in childhood and require intensive treatment and school accommodations. Not much is understood about the impact of chronic pain on cognition and emotion, but research suggests that when children are in pain it impacts their daily functioning.
According to research, the role of emotional distress and other aspects of cognitive impairment are apparent in patients with chronic pain. Various studies suggest that pain-related negative emotions and stress potentially impact a child’s ability to think, independent of pain intensity. This happens because when a child is in pain, certain areas of the brain are activated that cloud the way a child thinks and makes decisions.
Chronic pain can also result in anxiety, depression and reduced quality of life. However, its effects on cognitive abilities have remained unclear although many studies have attempted to psychologically profile chronic pain. A recent study hypothesized that performance on an emotional decision-making task may be impaired in chronic pain. This happens, in part, because brain regions critical for making choices are also involved in chronic pain. Evidence from brain imaging indicates that chronic pain is associated with a specific cognitive deficit, which may impact everyday behavior especially in risky, emotionally laden, situations. In other words, when a child is upset or stressed and trying to make decisions chronic pain only makes the situation worse.
Another important factor in considering the impact of chronic pain on a child’s thinking involves the common pain medications prescribed by physicians to manage pain. In an attempt to determine the source of cognitive impairment in 106 consecutively admitted patients at the Johns Hopkins Chronic Pain Treatment Center, EEG, intelligence scales, memory tests, and visual-spatial tests were administered. Patients receiving benzodiazepines alone demonstrated alterations in cognitive functioning and EEG. Patients receiving narcotics alone and a group of patients not receiving medication did not show signs of cognitive impairment. The effects of benzodiazepines on sleep and perception of chronic pain, in combination with the cortical changes that they produce, imply that these drugs should not be used in most patients with chronic pain. If a child has been given a benzodiazepine to manage pain, it very likely impacts the way their brain works.
If your child suffers from chronic pain he or she likely experiences changes in cognitive and emotional functioning. It is important to get your child’s school involved in order to ensure that proper accommodations are in place. Psychological care such as counseling and biofeedback can also help a child deal with the emotional aspects of chronic pain. Chronic pain in childhood is a serious condition, but it can be managed effectively to allow the affected child to live a very full academic and social life.
A comparison of cognitive impairment due to benzodiazepines and to narcotics; The American Journal of Psychiatry: 1980.
Cognitive impairment in patients with chronic pain: The significance of stress; Current Pain and Headache Reports: 2003.
Chronic pain patients are impaired on an emotional decision-making task; Pain: 2004.