Once a pain assessment has been completed, a pain management plan is developed. The plan will involve a multi-dimensional approach that may include the use of medicines (pharmacology), physical therapies, and psychological strategies that can all help relieve pain in children.
Further pain assessments will be conducted and the course of action will be adjusted or changed according to changing needs. For example, as a child’s injury heals and the pain subsides, the need for strong medications will be reduced. Often, the need for pain relief is short-lived and may only last for a few days.
Depending on the nature of the pain intensity and quality, administering pain medicines will be based on either a "step-up" or a "step-down" approach. This approach involves using weaker analgesics such as ibuprofen or acetaminophen in situations where the pain is not anticipated to be severe. If these do not relieve the pain sufficiently, the dosages or the type of medication will be stepped up until relief is achieved. However, when the pain intensity is expected to be severe initially, for example following major surgery, the plan will include regular strong pain medicines like morphine in addition to the weaker medicines and physical and psychological strategies. These medicines will be stepped down by reducing the dosage or removing the strong medicines as the pain intensity reduces and the child heals.
In conjunction with medications, the child and parents will be encouraged to learn behavioural coping strategies. These include the use of distraction such as reading and listening to music, controlled breathing, and relaxation. Once learned, these strategies can be very effective in controlling pain and other life stressors. Many hospitals have dedicated staff, often called Child Life specialists, who can help you and your child with developmentally appropriate strategies and resources.
Additionally, depending on the source of pain or injury, physical therapies such as physiotherapy, massage, heat, and cold will also be included as part of the pain relief strategy. For an infant, this might include skin-to-skin care, with baby placed on the mother or father’s chest.
All these strategies can relieve pain. However, since there are so many ways to relieve pain, finding the right combination can take time. Children are individuals and the way that they feel pain and react to pain treatment is also individual. Therefore, a treatment plan may require adjustments to achieve the desired effect. Making adjustments for maximum pain relief requires re-assessment and a certain amount of trial and error in terms of finding a strategy that works best for your child. Health-care professionals will continue to work with you and your child to help relieve pain and improve quality of life.
Expectations: Acute and chronic pain
Despite best efforts in managing pain, there are times that a pain-free existence may not be possible. When this happens, the focus turns to helping your child cope so that they may better manage normal activities of daily living such and attending school, sleeping well, participating in age-appropriate activities.