Pain management for common childhood pain and injuries

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Discusses pain management for common childhood pain and injuries such as ear infections, colic, and injections.

Minor injuries are a normal part of growing up for most children. Bumps, scrapes, and burns, if they are not serious, can be easily managed by parents at home. All that is needed is a little knowledge and some loving parental attention.

What can be more difficult is determining whether an injury or pain requires professional medical attention. If you and your child feel that medical attention is required, you will need to visit your family doctor, or the emergency department of a hospital for more serious injuries or painful episodes. Anyone taking care of your child, such as a babysitter, should also be prepared to do this.

When to seek help with pain management

Deciding whether to seek medical help can be difficult. It is the child who feels the pain of an injury, but it is up to you to figure out how serious the problem is. Some of the most common childhood pain experiences and how to manage them are outlined below. Being well informed is an excellent way to be more prepared to react to an emergency.

Common childhood pain experiences

Ear infection (otitis media)

This common childhood condition is an infection in the middle part of the ear. Other than baby check-ups, ear infections are the most common reason for children to visit a doctor. Ear infections are almost always painful. Usually, it results from sensitive structures in the ear being stretched. This is caused by the pressure from a blocked Eustachian tube, a channel that regulates air pressure within the ear and is needed for proper hearing. The infection may be treated with antibiotics. The pain may be treated with acetaminophen or ibuprofen, which can be given regularly during the day or around the clock, every four or six hours, if required. If the pain is still not well controlled, acetaminophen and ibuprofen can both be taken together. Be sure to read the label before you give your child any medicine.

Throat infection (pharyngitis)

Pharyngitis is caused by an infection of the pharynx, a part of the throat. It usually causes moderate pain that increases with swallowing. For a bacterial infection such as strep throat, antibiotics may be required to clear the infection and, indirectly, provide pain relief. The pain may be treated with acetaminophen and/or ibuprofen, which can be given regularly during the day or around the clock, every four or six hours, if needed.


All parents have sat up at night wondering how to help soothe the pain of their infant who is teething. Unfortunately, even though it is so common, there has been almost no research on this normal but sometimes painful childhood experience. Many parents report that their child has suffered mild to moderate pain during the teething process. Pain is related to inflammation or irritation of the gums. The use of cold or frozen teething rings may be a helpful physical strategy. You may also wish to speak to your doctor about mild pain-relieving medicines.


Colic typically begins at two weeks of age and lasts about four months. An infant with colic has unexplained screaming and crying fits that can last for hours at a time. While all babies cry sometimes, babies with colic scream and cry for longer periods. The crying may continue for more than three hours at a time, for three days a week or more, and for over three weeks.

Some studies suggest that as many as 25% of infants get colic. What causes colic is unclear. Gastrointestinal, psycho/social, and neurological developmental disorders have all been suggested. Colic usually goes away after four months and does not seem to cause any lasting injury.

While colic is alarming for many parents, there is some doubt concerning whether colicky babies are actually in pain. Colicky babies do not show the typical signs of pain stress, such as a sped-up heart rate and increased levels of stress hormones. Treatment recommendations include swaddling, rocking the baby or creating other gentle motions such as going on a car ride. Placing the baby near a white noise sources might also help.

Colic can be very trying for parents. Do not hesitate to seek help for yourself and your colicky baby if you are having trouble coping with the constant crying.


Needles used for immunizations, flu shots, or taking blood for tests are an unfortunate but necessary part of health care. Pain from injections is a major concern. Often, children learn early in their lives to associate a visit to the doctor with receiving a painful shot. Although there is work underway to find other methods to deliver key medicines and to take blood without needles, these are still experimental. In the meantime, health-care professionals have been concentrating on making injections less painful.

There are several ways to reduce the impact of pain. Telling your child what to expect is a good idea. Being honest and preparing your child gives them a feeling of control over the situation. This helps to reduce anxiety. What you should tell your child depends on their developmental age. What a parent does can range from playing with dolls for a young child to a discussion of the value of the immunization and a description of the sensation for an older child.

Other pain relief methods directly affect the pain caused by injections. These include ice or pressure on the site a few seconds before the needle and a sugar solution provided to infants on a pacifier or directly on their tongue (best used for babies under six months of age). Local anaesthetic creams applied to the skin may be used. One of these is EMLA cream. It provides good relief when applied about an hour before the injection or taking blood. Amethocaine (Ametop) is another that can be used; it works in about 20 to 30 minutes. In some places these creams may be available without a prescription. However, when using these creams, you need to know the area of skin where the injection will be given. This is not always possible. Parents also need to know about how to properly apply the correct dose.

Psychological treatments such as bubble blowing, distraction, and listening to music can all work to reduce the impact of pain. Parents can be taught to help coach their child to use these strategies. However, if the parent’s distress is obvious, it may further distress the child and it may be better not to be present.

The search continues for a better way to deliver medicines and take blood samples. Until this is found, both parents and health-care professionals need to use pain-relieving techniques for children receiving needle sticks. This will help all children to go to the doctor without fear.

Sprains and muscle pulls

Minor sprains and muscle pulls can be treated with heat or ice and an anti-inflammatory medicine such as ibuprofen​. In the case of pulled muscles, a gentle massage can often release the tension and the pain will ease. If the pain and discomfort from sprains and muscle pulls do not go away after a few days, parents need to seek medical help.

If the site of an injury is deformed, very swollen, or extremely painful, a fracture may have occurred. If you suspect a fracture, immobilize or splint the limb and seek medical help immediately. If the injury involves the neck or back, do not move your child. Call for emergency help.

Last updated: September 17th 2009