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.
Recurrent Neck Pain and Headaches in Preadolescents Associated with Mechanical Dysfunction of the Cervical Spine: A Cross-Sectional Observational Study with 131 Students. JMPT; 2009. Weber Hellstenius S.
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Sue A. Weber BSc, DC, MSc Chiropractic Paediatrics