Chronic Pain in Parents Linked to Pain in Adolescents
When both parents have chronic pain the chances their child has pain may double.
Does Overprotective Parenting Lead to Pain?
Norwegian researcher, Gry B. Hoftun, M.D., Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, is lead author of the new study which found that children living alone with one parent primarily had the strongest association between parental chronic pain and their own pain experience. This link could be due to overprotective parenting, a concentration on pain as experienced by the parent, or other factors not yet elucidated.
How the Study Worked
The work was published mid-November in the Archives of Pediatric & Adolescent Medicine and details a large cross-sectional health survey (HUNT [Nord-Trøndelag Health Study] 3) involving all inhabitants of one county in Norway aged 13 years or older. These participants filled out a questionnaire in order to describe their history of pain and were clinically examined, as were adults over twenty years old. The questionnaires from the adults and their offspring were then matched up using data procured from Statistics Norway; some 5370 adolescents were included in the study and matched to at least one parent involved in the research.
Chronic Pain in Teens and their Parents
Hoftun and colleagues employed strict criteria for the reported pain, with chronic nonspecific pain that which occurred in at least 1 location, unrelated to any known disease or injury, and which had been experienced at least once a week during the past 3 months. Chronic multisite pain was defined as chronic nonspecific pain in at least 3 locations. Neck pain in children may be accompanied by back pain, arm pain, headaches or other types of pain and can be caused by a multitude of factors.
Teens Twice as Likely to Suffer Pain when Both Parents Do
Using these definitions, the researchers noted that parental chronic pain was associated with chronic nonspecific pain and chronic multisite pain in their children. Adjustments for parental level of education and income, and the sex and age of offspring revealed an odds ratio for chronic pain in adolescents of 1.5 when maternal chronic pain was reported. Paternal chronic pain also had an OR of 1.5 for association with chronic pain in children. When both parents reported chronic pain the risk of pain reported by their offspring increased to and OR of 2.3.
Parents’ Focus on Pain – Is it Damaging?
That children of parents who both suffer chronic pain appear twice as likely to experience pain themselves may signify a degree of role modelling or learned pain behavior. Chronic illness and pain may also make parents more vigilant to the early signs of disease or dysfunction in their children, leading to a focus on pain, even if it is nonspecific and not considered serious.
Stress and Chronic Pain
The study’s authors were careful to control for socioeconomic status in order to try to reduce the potential effects of money worries on pain, both parental and in the children. The link with adolescent pain reports and both parents with chronic pain could suggest family distress, according to the authors, with anxiety and depression potential links. Stress and neck pain are certainly linked for many people, with muscle tension and sleeplessness all contributing to chronic pain.
Fathers and Mothers in Pain
The age of the children did not appear to alter the parent-child chronic pain relationship but family structure was a factor. Interestingly, those children living with their mother or with their mother and her new partner had a higher association with chronic pain (OR of 1.9). The associated risk for children living primarily with their father was not statistically significant at 1.8.
Predisposing Pain in Children
The study, which is one of the few to include information about both mothers and fathers, suggests that an emphasis be placed on parental management of their children’s pain and on the way they communicate their own experience of chronic pain. Longitudinal studies have been suggested to see if those children growing up with a parent suffering from chronic pain then have a higher risk of developing such pain themselves as an adult. With chronic pain, including neck pain and back pain, becoming so common it may be that the children of those with chronic pain are being set up for a lifetime of chronic pain themselves.
Chronic Pain in Children
Pain in children can have a number of effects, such as interfering with performance at school, with daily living and enjoyment of life, social activities, physical activity and sleep, particularly if neck pain occurs whilst lying down. The unique design of this study allowed independent reporting of pain by mothers, fathers and their offspring in order to remove the bias that is inherent when, as in most research, mothers report on both their own pain and their male spouse’s pain. The results suggest that the treatment of adults at pain clinics and children at dedicated pediatric pain clinics may need to be overhauled in order to allow for a comprehensive family approach to therapy.
Does the Stress of a Sick Child Trigger Parental Pain?
The study did not investigate the timing of pain in the children and their parents and so could not draw conclusions about the potential for parental stress over their children’s pain inducing their own chronic pain. Decreasing parental stress over a sick child can help avoid parental ill-health and may help improve the outcome for the child, with some researchers working on interventions designed to do just that. Children are less likely than their parents to be experiencing chronic back or neck pain from degenerative spine conditions but it may be that having parents with chronic pain increases your own risk of chronic pain, at least in adolescence.
Reference
JB. Hoftun, MD; Pål R. Romundstad, PhD; Marite Rygg, MD, PhD., Association of Parental Chronic Pain With Chronic Pain in the Adolescent and Young Adult: Family Linkage Data From the HUNT Study, Arch Pediatr Adoles Med. Published online November 19, 2012.
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