Chronic Pain and the Teenager

Girl in bed sick
Adolescence can be challenging for any teenager and chronic pain is an additional challenge. As well as medical considerations, chronic pain can influence relationships with family and friends and may have an impact on self-image. Pain may also restrict or interfere with school, recreation, and work activities.

Pain can also delay normal developmental transitions. It may delay going to college or university, or moving out of the home because of ongoing medical tests, treatments or debilitating pain.

What is perhaps most important, though, is that as your child grows into a teenager, the responsibility for coping with chronic pain will eventually shift to her. As your child moves through her teenage years and becomes an adult, she will gradually take on increasing responsibility for all aspects of her pain management.

The major part of this transition will take place during the teenage years. At all times during this process, the best way to minimize the adverse impacts of chronic pain is to keep her as informed as possible.

Role of the parents

Parents can help when their child is younger by encouraging her to develop healthy ways of thinking about and coping with chronic pain: for example, providing relevant information, involving her in decision-making as early as possible, and teaching her problem-solving skills. Always encourage your teenager to express her feelings and concerns about her pain and together you will find ways to address them as she grows to adulthood.

When the time is right, your teenager can begin to take responsibility for her own pain management by beginning to meet with health care providers on her own. These unsupervised visits can be phased in over time as the teen feels comfortable. They will help her begin the transition to taking full control of her care. They will also give her the opportunity to discuss more private or delicate issues without parental involvement. Going to appointments alone will get your teenager used to the idea that soon, this responsibility will be entirely her own.

As your teenager takes more responsibility for her own care, some of her decisions may cause problems. Teenagers need to feel confident that they can discuss what happened with their parents without fearing criticism or a reprimand. Reinforce your confidence in her ability to make decisions on her own without being too critical. It is important to encourage your teen and offer support as needed to help her make wise decisions.

When needed, consult a health professional with expertise in dealing with teenage issues, such as a social worker, a psychologist, a psychiatrist, or a specialist in adolescent medicine. A consultation is especially important if your child engages in risky behaviour or seems unable to cope with emotional issues.

Tips for remembering pain medication

It is not always easy to remember when to take pain medication. Teenagers have busy lives and it may easily slip their minds. Taking medications is often seen negatively, as a burden, a lack of control, or a reminder of a condition they would rather forget. Some teens are not experiencing symptoms that would remind them of the need to take medication. In spite of these potential problems, following medication routines is a critical part of taking responsibility for managing pain and can be crucial for optimal pain relief and safety. Here are some tips that you can encourage your teen to adopt:

  • Incorporate pill-taking into daily routine by connecting it with another daily activity, like taking a shower in the morning or brushing teeth at night.
  • Encourage the use of a pill container of their choice so it is clear what needs to be taken and when. If your teen does not want to carry a pill container around, consider a container-shaped watch, ring, or earrings that are designed to hide pills.
  • Consider an electronic reminder to remind her to take her pills. Computers, personal digital assistants, or digital wristwatches can all be programmed to give a brief alarm.
  • If your teenager breaks her routine, for example, by going away for the weekend, there is an increased risk of forgetting to take pills. Parents can assist by making sure medicine is carried and stored in some accessible but safe place such as a cosmetic bag or purse.

Letting go

At some point, all parents struggle with their teen’s growing independence. For many parents, letting go is a difficult process. For parents of a child with chronic pain, this can be even harder than usual. After having spent so much time overseeing their child’s care, it is sometimes difficult to encourage independence and watch her assume responsibility for her own care. Some parents may even resist their child's efforts to become more independent.

But parents need to come to terms with their children taking control of their lives to ensure that they will be able look after their own health as adults. Some hospitals have support groups that enable parents to discuss these "letting go" issues. If your teenager is well prepared, she can be trusted to look after herself in a competent manner. Proper preparation means making sure that she knows all she needs to know about her condition, its management, and the repercussions of not taking care of herself.

How will your teenager cope with greater independence?

Some teens eagerly embrace their growing independence and responsibility for their own care. Others are fearful and may continue to rely heavily on their parents. It is important to find a middle ground. Parents can continue to provide some support while they encourage their children to take steps on their own. The ultimate goal should be to gradually transfer complete responsibility of the care from the parent to the adolescent.

Your teenager should understand that major life decisions concerning education, career, and living arrangements should be made keeping in mind how her chronic pain will be managed and how it will influence her overall health and well-being. Being "realistically optimistic" about what is and what is not possible about the future is the key.

Teenage drinking and drug use

The adolescent years are the time when many teenagers begin to experiment with risky behaviours such as taking drugs and drinking alcohol. Substance use and abuse is a concern for all parents with teenage children. Teens in chronic pain, especially those who are taking medication for their condition, may have to take special care. A concerted effort on the part of both parents and teens should be made to reduce the possible hazards of substance abuse.

Teens need to be aware of the potential dangers associated with combining alcohol or drug consumption with their pain medications. Both alcohol and drugs have the potential to interact negatively with medication. Sometimes, the interaction may make the medications less effective. In other cases, the combination can be very dangerous or even deadly. It is best to check with your health care provider to know how to proceed. At the very least, moderation is key.

Teens may also benefit from learning about strategies for coping with peer pressure to take drugs. For example at a party, humour can be used as a means of deflecting attention. One quick response might be "No thanks, I'm already on more drugs than anyone here!" Teens need to be aware of all the choices they can make, including making new friends who do not use drugs. They should learn to feel comfortable saying no and walking away from an uncomfortable situation.

Peer influences can go beyond the pressure to drink or take drugs. It may also include the pressure to share. If your teen is taking strong medications for pain relief, it is likely that at some point, someone will ask her to share her medications. Teens should know that sharing their medication is illegal and potentially very dangerous. They should also understand that the responsibility for such an action rests with them.

Talking openly and non-judgementaly to your teenager about her choices is the key to helping her to make sound decisions. A physician or counsellor specializing in adolescent issues with whom your teen can talk privately could also provide her with useful guidance. If you are concerned that your teen is engaging in risky behaviour, you should seek the support of a substance abuse counsellor.

As a parent, be aware that your child may engage in drug abuse. Do not assume that because your child has a chronic condition and is aware of how "street" drugs or alcohol can potentially affect her condition, that she will always make the right choice and not take them, especially when there is pressure to do so from peers.


Danielle Ruskin, PhD, CPsych