There is an association between chronic pain experienced by parents and chronic, unspecific pain experienced by teenagers, according to recent research from the Department of Laboratory Medicine, Children’s and Women’s Health (LBK) at NTNU.
“This is an interesting find, and it is probably caused by a mix of environment and genetics,” says PhD candidate Gry Børmark Hoftun.
“When we looked at teenagers with divorced parents, we saw a stronger association between pain experienced by teenagers and pain in the parent with whom they lived. For example: In teenagers living with their mother, there was a strong association between pain experienced by the mother and pain experienced by the teenager, but there was no clear association with father’s pain.”
This last finding indicates that environment is of great importance. That is, parents can act as role models for their children – pain is something the teenagers learn.
“These findings are useful when examining or treating children with chronic, unspecified pain. It is important to make the parents aware of this association and that children learn behaviour patterns from their parents. In other words, it is important not to focus too much on their own or their children’s pain. One should rather promote the use of distraction techniques,” Hoftun says.
Nearly half experience chronic pain
Nearly half (44%) of the 7373 teenagers who responded to the pain related questions in the health study Ung-HUNT 3 said they experience chronic, unspecific pain – that is, chronic pain with no obvious medical cause.
Most of these said they had pain in more than one location, and 80% said the pain affected leisure activities and every-day life.
This is important knowledge, not least to reassure parents worrying that children with chronic pain suffer from serious disease. Most often this is not the case – it is in fact quite common that children and teenagers experience pain, and it is usually due to factors other than serious illness.
Girls more affected than boys
There are also many more girls than boys suffering from chronic pain. As many as 54% of the girls say they suffer from pain, as opposed to only a third of the boys. But is it really the case that girls experience more pain than boys?
“The girls do report more pain for unknown reasons, but it could have something to do with gender roles – whereas boys are supposed to be ‘tough’ and handle pain, girls talk more about it and share more with their friends. Sex hormones may also have an impact, as several studies have shown that the difference between boys and girls arises when they hit the teens – and it has been shown that sex hormones affect pain paths differently,” Hoftun explains.
“At the same time both anxiety and depression are more common among girls, and these are also associated with chronic pain.”
The researchers also looked into other factors associated with chronic pain.
“What show the greatest association with pain among teenagers are symptoms of anxiety and depression,” Hoftun says.
She warns, however, that this specific study cannot say whether anxiety and depression cause chronic pain, or whether pain over longer periods leads to anxiety and depression. There is some support for the first hypothesis though in other studies.
“We also saw that being overweight, smoking and alcohol are strongly associated with pain,” she says.
This is knowledge which could prove useful when meeting teenagers who are referred to hospital for chronic, unspecified pain. At the same time as asking the teenagers about smoking and alcohol, one can make them aware of the connection. This could then be a starting point for treatment and to promote a healthy lifestyle.
In addition, one needs to focus on mental health and offer help if there is suspicion of anxiety or depression, or other mental problems.
Does it pass?
It would be interesting to follow-up the teenagers from HUNT 3 to see how many of these still suffer from chronic pain as adults, and to see what characterised these during their teens, Hoftun concludes.
Gry Børmark Hoftun will defend her thesis Chronic Non-Specific Pain in Adolescence Prevalence, Disability, and Associated Factors – Young-JHUNT and HUNT 3, 2006-2008, at 12.15 on Friday 30. November in the Auditorium at MTFS.
She will hold a trial lecture at 10.15 in the same place.
- Chronic idiopathic pain in adolescence–high prevalence and disability: the young HUNT Study 2008. Hoftun GB et al.
- Factors associated with adolescent chronic non-specific pain, chronic multisite pain, and chronic pain with high disability: the Young-HUNT Study 2008. Hoftun GB et al.
- Association of Parental Chronic Pain With Chronic Pain in the Adolescent and Young Adult Family Linkage Data From the HUNT Study (link not yet available).