Sue Weber BSc, DC, MSc

BACKGROUND: There is a paucity of information in how best to gather information regarding how children experience pain and if there is a correlation between how children and parents report the child’s pain.

OBJECTIVES: To establish if there were differences: between how children and parents report whether the child has pain and how often the child suffers from pain; whether the child had suffered trauma to the head or neck; and how intense the child reports their pain.

DESIGN: A cross-sectional observational study among pre-adolescent students in Sweden.

METHODS: Students from a Swedish municipal school (n=131) aged 10-13 years were given a consent form to take home to be signed by their parents. The consent form included questions about the child and investigated whether: the child had experienced an injury to the head or neck; if the child had neck pain and/or headache; and how often the child had neck pain and/or headache. All students completed their own questionnaire in the classroom.

RESULTS: Of the 131 children, 40%(n=52) complained of neck pain/headache.  The parents were asked if their child complained of neck pain/ headache; 6.1 % (n=  8) answered often; 20.6 %(n=27) answered sometimes; 27.5 %(n=36) answered seldom.  Thirty-one percent (n=41) of students reported neck pain and/or headache often. Seven students reported daily, 8 claimed 3-5 times a week, 26 answered 1-2 times a week, 9 checked once a month and 7 checked once every three months. The parents were asked if their child had experienced trauma to the neck or head and 21.3 % (n=28) responded yes.  Sixty-one percent (n=80) of the children reported trauma to the head/neck. Students reported having fairly high levels of pain and having pain often. For usual pain intensity during episodes, on a VAS scale, 6 was the most common answer; for the worst episodes, 7 was the most common answer. Girls reported lower average pain intensity (3/10) when compared to boys (6/10). Of the children who complained of neck pain/ headache, 17 % (n=9) sought some kind of help.

The degree of disability children experienced with neck pain/ headache was investigated by asking how it affected their activity level.  Children could choose more than one answer.  Nearly 30 %(n=16) said that it didn’t bother them; 18.7%(n=10) said they could feel it all the time, but did what they usually do; 12.5 %(n=7) felt pain when they thought about it; 7.8%(n=4) had difficulty concentrating; 7.8 %(n=4) could only participate in activities at half speed; 10.9 %(n=6) reported they couldn’t participate in activities; 12.5%(n=7) wrote that they had to lie down; and 7.8 %(n=4) missed school.

CONCLUSIONS: Findings from the study showed that there was discrepancy between parental report and the child’s self-report of trauma history and neck pain and/or headache. The results from the VAS scale and the degree of disability reported are not congruent. Children reported frequent, high levels of pain, unreported by parents.

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Sue A. Weber BSc, DC, MSc Chiropractic Paediatrics