Not every child experiences pain during a hospital stay, but if it does occur, reading this information should help you:

• Learn why pain control is important for recovery as well as comfort.
• Play an active role in helping to manage your child's pain.

If you think of other questions or have concerns not addressed here, please be sure and ask your nurses or doctors.

What is pain?

Pain may be described as a feeling of hurt or strong discomfort and is the body's way of sending a message to the brain that an injury has occurred (such as surgery). Pain medicine blocks these messages or reduces their effect on the brain.

We have learned that unrelieved pain causes the body to release certain chemicals that may actually delay healing, so it's important to work with your child's nurses and doctors to help control the pain.

Measuring your child's pain using the pain scale

Your doctors and nurses will rate pain on a scale from 0 to 10 (0 being no pain, 10 being the worst pain that can be imagined). Older children can understand this scale, but younger children can use cartoon faces or will be observed frequently for behavioral and physical signs of pain or discomfort.

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Explain to your child that each face is for a person who feels happy because he has no pain (hurt) or sad because he has some or a lot of pain. Face 0 is very happy because he doesn't hurt at all. Face 2 hurts just a little bit. Face 4 hurts a little more. Face 6 hurts even more. Face 8 hurts a whole lot. Face 10 hurts as much as you can imagine, although you don't have to be crying to feel this bad. Ask your child to choose the face that best describes how he is feeling. Rating scale is recommended for people age 3 years and older.

How will pain medicines be given?

Pain medicines can be given a number of different ways, depending on the needs of your child. Some of the ways are:

• By mouth (such as a pill or liquid).
• By injection (such as into the skin or into the IV tubing).
• For some children, a PCA (Patient Controlled Analgesia) pump may be used.

Ask your nurse or doctor about pain medicines for your child.

Non-drug pain relief

Another means of relieving your child's pain is through the use of non-drug methods. These methods can be effective for mild to moderate pain and help to boost the pain relief effects of drugs. Like pain medicine, each non-drug method works differently for different types of pain. A few of the most useful methods in children are:

• Use of heat or cold (check with your child's nurse)
• Distraction (music, video games, TV, stories, blowing bubbles, puzzles)
• Relaxation (breathing exercises, rocking chair)
• Massage (bed bath, gentle back rub, lotion)
• Rest (dimming lights and reducing noise, encouraging sleep)
• Changing position (use of pillows, sitting up)
• Imagination (creating stories, drawing pictures)

Talk with your child's nurse about which of these methods would work best for you and your child.

Common concerns and facts about pain

"Taking drugs for pain is a sign of weakness."
FACT: Untreated pain can decrease the quality of life and harm health, no matter how strong a person is. Less pain means less stress on the body and the mind, and faster healing.

"I'm afraid that my child will become addicted or hooked."
FACT: When pain medicines are given and taken in the right way, patients rarely become addicted to them.

"My child is sleeping and never complains, so she must not be feeling any pain."
FACT: Children respond to pain in many different ways. Sleeping may mean that your child is comfortable, or may be your child's way of "shutting out" the pain.

How you can help manage your child's pain

1. Ask the doctors and nurses how much pain to expect and how long it should last. Being prepared helps put you and your child in control.
2. Talk with the doctors and nurses about pain control methods that have or have not worked for your child in the past.
3. Tell the nurses what words and signs your child uses to tell you that he or she is hurting.
4. Tell your doctors and nurses about any allergies your child may have.
5. Ask about any possible side effects with pain medicines your child might be receiving. Sedation is a common side effect.
6. If you think your child is in pain or the pain is getting worse, tell the nurse so it can be addressed quickly. Relief is easier to obtain if acted upon early. This is a key step in proper pain control.
7. Consider the non-drug methods listed above that you can do with your child to help relieve the pain.
8. Don't tell your child that the nurses will give him a "shot" if he misbehaves. This may create unnecessary fear of something that might be a very important part of your child's recovery. Injections are only given when other methods are not available.

Also, keep a list of any questions that you would like to ask your child's doctors or nurses.

Text is adapted from a publication of the US Department of Health and Human Services,
Public Health Service, Agency for Health Care Policy and Research, 1992.

Wong-Baker FACES Pain Rating Scale is from Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong's Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301. Copyrighted by Mosby, Inc. Reprinted by permission.

These are general guidelines only. Please consult your physician regarding any specific treatments or questions you may have about your care.