Chronic Pain in Adolescence: What's Different, What's the Same?

Author: Melissa Geraghty

What I have found in the research as well as from my clinical experience has been that adolescents are often paired with pediatric and geriatric populations in the studies as well as treatment. But adolescents differ in many ways on biopsychosocial and spiritual levels. Biologically, the brain is functioning differently than pediatric and geriatric populations. Psychologically, due to brain maturation and other factors, adolescence is broken up into even more categories, such as early adolescence, middle, and late. And then socially, adolescents are very much in tune with their social environment, with their peers, so that affects family interactions and treatment. And then finally spiritualityoftentimes chronic pain can be a reminder of one’s mortality, so an adolescent who perhaps thinks that, “Nothing’s going to happen to me. I’m fine.” is profoundly affected by chronic pain. It questions their whole identity; who they are and what their purpose is. The interesting part of adolescence and chronic pain is just that there’s not a lot of research on it at all. We need to find more evidence-based treatments for the adolescent at all levels and make sure that all providers are communicating with one another. We need to treat the adolescent from a biopsychosocial spiritual component and model, so that they’re getting the best care possible

In terms of pain conditions encountered, they are frequently injury-resultant. It could be car accidents or just some sort of accident, whether it’s gymnastics, or concussions, or football injuries. In my experience, teenage males have more of the experiences that relate to violent or traumatic injuries. Not to say that the ladies don’t either because they certainly are, but with the males, pain is more the result of aggressive injuries. And because many providers are not properly trained in chronic pain management, an adolescent who will come in with an acute injury will be just treated for the acute injury, and may be not followed up on. Acute pain can become chronic and if the adolescent or their family are acting on the belief that teenagers are resilient, they’ll be fine, they are going to heal, they may not be promptly treated. Then they are stuck in the cycle of chronic pain which is a lot more complex than if we were just dealing with acute pain in the first place.

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