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Long-Term Effects

Mom comforting Daughter 
Researchers have provided information that can improve the ways in which pain is assessed and treated. At the same time, they have described the previously unknown and negative long-term effects of pain. As a result, pain issues are taken much more seriously today than in the past. The provision of optimal pain relief is now an independent goal of treatment. For example, good pain control in children following surgery allows the child to walk earlier, do deep breathing, and get better sleep, all of which generally promote faster healing.

Acute pain causes a release of " fight or flight" stress hormones. These stress hormones cause a breakdown of body tissues, as well as an increase in heart rate and blood pressure. The end result is a strain on the immune system which can complicate the effects of injury and slow down recovery. For the very young infant, the effects of stress may be associated with significant illness and may affect survival.

Consequences of pain for babies and children

There has been an enduring belief that pain does not have long-term consequences. It is also falsely believed that babies and young children cannot remember painful events. These beliefs have resulted in the notion that pain in a young child is not important in their immediate or future development. However, researchers are accumulating information that indicates that these claims are false.

Some research now suggests that there are long-term consequences of pain in infants. This is especially the case for babies who spend a long time in hospital early in life and undergo many painful procedures without the benefit of any pain relief medication. However, researchers are also showing that the young child’s brain is very adaptable, or "plastic", in the way it deals with painful events. As a consequence, the brain is often able to find ways to compensate for these early pain events. Other research shows that babies who suffer a lot of pain from procedures early on without effective pain relief may go on to develop further pain as they grow older. They may also respond differently to pain during future pain events.

Furthermore, there is some evidence that children whose pain was managed adequately in the hospital are less likely to need to return to the hospital for another visit. They also use other health care services less frequently.

There is a lot more that we need to learn about how pain specifically affects children in the early years of their lives and what repercussions pain has as they develop into older children, teenagers, and adults. At the same time, researchers continue to show that when pain is not appropriately relieved, it has many negative consequences that may be long-lasting.

Other negative effects of long-term pain

Early painful experiences and high doses of morphine​ frequently leave a permanent imprint on the developing nervous system. Untreated acute pain contributes to an increase in the excitability of the central nervous system. This prolongs pain and creates a biological memory of pain.

Most children do not become used to repeated painful procedures over time. In fact, their anxiety can increase and they may respond with much more negative behaviour when faced with a repeated painful event. If procedural pain, such as getting a needle, is not well managed during the first instance of a procedure, children can develop increased anxiety about the next time they face this or similar procedures. Such increased anxiety leads to greater pain intensity, which may make the management of pain relief medications more challenging.

In summary, the inadequate treatment of pain in babies and children produces not only physiological pain problems, but also psychological, behavioural, and social challenges.

Danielle Ruskin, PhD, CPsych

9/9/2009




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