By Jonny Lupsha, News Writer

Parents of children living with chronic pain are opening up about their kid’s experiences, The Huffington Post reported. From debilitating joint pain to constant migraines for months on end, children as young as age 2 suffer from chronic pain and its consequences. So how is chronic pain defined?

According to the The Huffington Post article, which is the fourth in a nine-part series on pain in America, anywhere from 5 percent to 38 percent of children suffer from chronic pain. It manifests as migraines, joint pain, abdominal pain, and even malfunctioning brains and nervous systems that convince the child they’re in pain all the time. Chronic pain is still largely misunderstood, and its causes are often unknown. All sorts of medical tests come back with normal results, yet the pain persists. So what’s going on?

Chronic Pain Vs. Acute Pain

Everyone is familiar with acute pain. Whether we stub a toe or get a paper cut, we’ve all experienced it.

“Acute pain is self-protective—it’s a warning that something is wrong with our bodies and we need to do something about it,” said Dr. Barbara K. Bruce, Clinical Health Psychologist in the Mayo Clinic Department of Psychiatry and Psychology. “Acute pain may be minor or it may be severe, but as you heal, it goes away. Chronic pain is a different story.”

According to Dr. Bruce, who is also Associate Professor of Psychology at the Mayo Clinic College of Science and Medicine, chronic pain either never goes away, comes back again and again, or emerges asymptomatically. She said it can stem from many different health issues.

“Back, neck, and other joint issues can cause chronic pain,” she said. “Osteoarthritis and rheumatoid arthritis can cause it. And then there are conditions such as fibromyalgia and irritable bowel syndrome which are characterized by very real long-term pain.”

Additionally, chronic pain can be caused by serious illness, such as cancer. Dr. Bruce said that cancer-related chronic pain can come from the disease itself, treatments, or tests.

Pain Relief

For decades, doctors have prescribed opioids—which Dr. Bruce defined as “synthetic cousins of opium and the drugs derived from it”—to deal with chronic pain. Prescriptions for opioids such as oxycodone, fentanyl, and other painkillers have soared, but unfortunately, so have addiction and death rates.

“Opioids, just like real opium, mimic the natural pain-relieving chemicals produced by our brains—the endorphins,” Dr. Bruce said. “These drugs bind to the endorphin receptors in the brain and reduce the activity of nerve cells throughout the body. In other words, opioids turn down the volume on not only your pain but on all the nerve signals in your body.”

However, over time, our bodies adjust to the drug and our tolerance to it rises. Patients take more at a time to get the same amount of pain relief and can overdose, often leading to death. Other times, when the prescription is withdrawn, the patient may turn to illegal alternatives, including heroin. In still other cases, suppressing our autonomic processes with painkillers can lead to respiratory depression, which means we simply stop breathing. The opioid crisis in America is just beginning to be combated.

There are alternatives to painkillers, some of which have proven effective in many cases.

“A growing body of evidence points to interdisciplinary pain rehabilitation programs or pain management programs as the best solution for chronic pain,” Dr. Bruce said. “When the American Pain Society’s Task Force on Comprehensive Pain Rehabilitation reviewed the clinical research on patient outcomes, they found that comprehensive pain programs not only provided the most effective treatment for chronic pain, but they were the most cost effective as well.”

Pain rehabilitation programs generally focus on identifying and changing the factors in our lives that cause chronic pain, and often they go far beyond the obvious related illness, injury, or lifestyle habit.

While many aspects of chronic pain are still a mystery, doctors are working to understand more of it, all the time. With luck, the children who suffer from it today may not have to endure it their whole lives.

Dr. Barbara K. Bruce, Ph.D., L.P., contributed to this article. Dr. Bruce is a clinical health psychologist in the Mayo Clinic Department of Psychiatry and Psychology. She holds a Ph.D. in Clinical Psychology from Louisiana State University in Baton Rouge, where she also earned her Bachelor’s Degree in Psychology. In addition, she holds a Master’s Degree in Physiological Psychology from the University of New Orleans.