From a renowned expert in the field, a parent's guide to managing their child's chronic pain—to give back normal life to the 1 in 5 children for whom pain is a serious problem. A child's chronic pain undermines school performance and social and emotional health, erodes finances, and devastates the family.
This book reveals what parents can do to alleviate their child's pain on a daily basis. Dr. Zeltzer's clinic is renowned for treatment of pediatric pain stemming from headaches, arthritis, irritable bowel syndrome; fibromyalgia, and more, via a multidisciplinary approach including specialists in psychiatry, hypnotherapy, yoga, acupuncture, biofeedback, and others. Based on more than 30 years study, Dr. Zeltzer offers ways to take control of the pain and ultimately become pain-free. She explains how to tell if the pain has become chronic, soothe the nervous system, reactivate the body's natural pain control mechanisms, which medications are most effective, breathing, muscle relaxation and visualization techniques, how to reduce parents' guilt and much more.
It is never too late to treat pain in children, no matter how long it has lasted, says Dr. Zeltzer. Her book offers help and hope to families desperately in need.
What Is Pain?
That which hurts, also instructs.
-- Benjamin Franklin
Mark is a 14-year-old whose gastroenterologist could not
find a cause for the chronic esophageal pain he had had
for four months, during which he was unable to eat, sleep, attend
school, or engage in other normal activities. Mark initially had
developed significant pain when swallowing, which continued
until a yeast infection was diagnosed and treated. By that time,
however, he had had the pain for six weeks and had missed the
first month of school. After the infection was gone, his pain remained,
despite a normal-appearing esophagus. Mark began
spending hours during the day crying, moaning, and scratching
at his chest. Instead of getting better, his pain was getting worse.
• • •
It can start quite suddenly.
Your daughter complains about a stomachache, which you attribute to the fast food she gobbled down at dinner the night before. Soon you notice
she is complaining of similar aches in her stomach every few days. A
couple of days later, you notice her limping and rubbing her leg. When
you ask her about it, she says her leg feels hot and prickly. The complaints
seem unconnected, but you take her to the pediatrician for the stomach
problems. The doctor attributes the stomachaches to nerves. "After all,"
he says, "the new school year is approaching." The leg pain, he attributes
to normal "growing pains." "All children get them," he assures you. Fastforward:
It is one year and dozens of doctors later. Your daughter is still in
pain. In fact, the pain is much worse and has traveled to other areas of her
body. She is attending school sporadically, and she shows little interest in
the things she once loved, such as her friends and gymnastics. What's
more, you are still no closer to knowing what is causing the pain. Your
nerves are frazzled; you are missing work, are fighting with your husband,
and feel guilty all the time. "How did this happen?" you ask yourself.
Pain is much more than an uncomfortable sensation that we all
would like to keep our children from experiencing. It can affect a child's
ability to breathe easily, perform everyday tasks and activities, and eat
normally. It also interferes with sleep and energy, and it alters mood and
You may be just beginning the journey to understanding your
child's pain, or you may have been struggling with it for years. You may
be feeling many of the symptoms of what I call the "parent pain burnout
syndrome" -- fear, confusion, frustration, anger, and helplessness. You are
not alone. One in five children in the United States suffers from some
form of chronic pain. That means that at least the same number or more
parents are suffering right along with those children.
Pain, in one form or another, is a part of every child's life experience.
Some children are fortunate to experience only common cuts and
bruises, whereas others experience more serious injury, illness, or disease.
Some types of pain can be useful, because they teach children what is dan-gerous (e.g., touching a hot stove) or alert parents to a condition that
needs immediate attention (e.g., acute pain in the right lower belly associated
with appendicitis). However, chronic pain never serves a useful purpose.
It is the most misunderstood of all childhood conditions for which
parents seek pediatric help.
Chronic Versus Acute Pain
Teresa, nine years old, had the flu and developed abdominal
pain. Two different doctors told her that it was just the flu and
not to worry. However, her belly pain got worse. It turned out
that she had a ruptured appendix; she spent two weeks in the hospital.
(Parents: Most cases of appendicitis are readily diagnosed
not only by belly pain but also by physical examination and the
child's white blood cell count, so please don't worry every time
your child has a stomachache.)
Teresa had a five-inch incision from her navel to her pelvic
bone that had to remain open to allow the wound to drain. She
experienced severe postoperative and daily procedural pain when
the surgeons cleaned her wound. After Teresa came home from
the hospital, her mother, Deana, had to clean the wound so that it
would continue to drain. This daily process caused Teresa excruciating
pain. For Deana, performing this task while her child
screamed in pain was torture. The wound eventually drained and
healed, but Teresa's belly pain persisted.
Teresa started to fear going to the bathroom because of
the pain and began having trouble sleeping at night. The director
of pediatric surgery at the hospital and two specialists told Deana
that Teresa's pain was "all in her head" and that she "was going
to have to live with it." They also believed that Teresa must have
"a low pain tolerance" -- rather ironic, considering what she had
Finally, a gastroenterologist was consulted. He was appalled
and told Deana, "No child should have to experience or
live with this kind of pain." A simple statement, but it was a
tremendous relief to both Teresa and her mom because they had
begun to feel that they were crazy. Despite his empathy, however,
the gastroenterologist did not know how to help Teresa.
Today, nearly five years later, Teresa still suffers from some
pain, although she has found many ways to alleviate much of it --
including massage, Iyengar yoga, biofeedback, and low doses of
the antidepressant Elavil and the antianxiety drug Effexor.
• • •
Pain generally has two basic forms -- acute and chronic. Although most
people think of all pain as pretty much the same and so approach it the
same way, there are important differences between the two. Approaching
them with the same mind-set may result in prolonging a child's chronic
pain. Also, inadequate treatment of acute pain or pain associated with
medical procedures or injuries may actually worsen chronic pain or lead
to the development of chronic pain.