Types of Pain and Methods of Pain Assessment in Children

Types of Pain and Methods of Pain Assessment in Children

Definition of Pain:

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pan is a subjective feeling or individual response to noxious stimuli on the sensory nerve endings.

Types of pain and methods of pain assessment in children
Fig: Types of pain and methods of pain assessment in children

Classification or Types of Pain in Children:

1. According to time:

a. Acute pain: Occurs abruptly after an injury or disease. Persists until healing occurs and often is intensified by anxiety or fear. Examples-Bone fractures, bums, surgery, sickle cell crisis, tension headache, delivery.

b. Chronic pain: Pain lasts for a prolonged period of time. Cannot amenable to specific treatment. It is two types-

Chronic nociceptive pain.

  • Gastritis,
  • Stable angina,
  • Prolong tissue pathology,
  • Pancreatitis,
  • Gout.

Chronic neuropathic pain:

  • Abnormalities in the PNS or CNS,
  • Low back pain,
  • Diabetic neuropathy.

2. According to pathophysiology:

a. Nociceptive pain:

Pain resulting from activation of primary afferent nociceptors by mechanical, thermal or chemical stimuli.

b. Neuropathic pain:

Pain resulting from damage to peripheral nervous or central nervous system tissue or from altered processing of pain in the CNS.

3. According to the origin:

a. Superficial pain: Originate in the skin and subcutaneous tissue.

b. Deep somatic pain: Pain arises from ligament, tendon, blood vessels etc.

c. Visceral pain: Stimulation of pain receptor in the abdominal cavity, cranium and thorax.

4. According to where it is experienced in the body:

a. Radiating pain,

b. Referred pain,

c. Phanthom pain,

d. Shifting pain.

Factors Influencing Pain in Children:

1. Physical factors:

Many physical factors influence the pain experience, including the individual’s pain threshold, pain tolerance, age, physical activities, and nervous-system integrity.

2. Psychological factors:

Along with physical factors, several psychological factors can influence the response to pain, including culture, religion, past experience with pain, anxiety and situation factors.

Methods of Pain Assessment in Children:

Because pain is both a sensory and an emotional experience, using several assessment strategies provides quality and quantitative information about pain.

QUEST is the best way to assess pain of a child.

  • Q- Question the child,
  • U- Use a pain rating scale,
  • E- Evaluate the behavior and physiological changes,
  • S- Secure parents involvement,
  • T- Take cause of pain into account T-Take action and evaluate results.

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