Understanding and managing children's recurrent pain in primary care: A biopsychosocial perspective

Area of Science:

• Pediatrics
• Psychology
• Family Medicine

Background:

• Recurrent pains in childhood, defined as occurring >=3 times within 3 months and interfering with daily life, are common.
• Headaches and abdominal pain are the most frequent types, often without identifiable physical pathology.
• A functional analysis of pain's antecedents and consequences is crucial.

Purpose of the Study:

• To outline a biopsychosocial approach for understanding and managing recurrent childhood pain.
• To suggest interview questions for assessing pain triggers and consequences.
• To highlight effective intervention strategies.

Main Methods:

• Functional analysis of pain episodes, considering physical and social triggers (e.g., school stress, family modeling).
• Assessment of pain consequences (e.g., sleep issues, avoidance behaviors, parental reinforcement).
• Review of evidence-based interventions, particularly relaxation skills and cognitive-behavioral therapy.

Main Results:

• The majority of recurrent childhood pains are functional, not due to serious physical illness.
• Effective management requires a shared biopsychosocial understanding between child, family, and clinicians.
• Relaxation skills and cognitive-behavioral strategies are well-established interventions.

Conclusions:

• A cognitive-behavioral, biopsychosocial approach is research-supported for treating recurrent childhood pain.
• Primary care physicians and pediatric consultants play a vital role in prevention and relief.
• Understanding and addressing psychosocial factors is essential for managing childhood recurrent pain.