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Alternative Methods to Treating Chronic Pain in Kids and Teens

Chronic pain in kids and teens may not be widely known, but it is quite common. In the last 10 years, reports from the International Association for the Study of Pain show that 25 to 37 percent of children and adolescents reported chronic pain, which is pain that persists for months or even years. In about five percent of those cases, the chronic pain was moderate to severe enough that it negatively impacted their physical, psychological and social functioning. William Frye, Ph.D., is a psychologist at Johns Hopkins All Children’s Hospital and shares what causes it, when to see an expert and alternative options to opioids for treating pain.

What causes chronic pain?

Chronic pain is complex and can develop from many problems including injury, surgery, illness, infection and chronic disease. However, a growing body of research has shown that chronic pain in youth can begin without an identifiable cause. Other factors such as trauma, anxiety, depression and general high levels of stress can contribute to the development and maintenance of chronic pain.

When should your child see a pain expert?

Many youth are initially seen by their pediatrician and benefit from early treatment of injuries or lingering pain. A general guideline is to see a pain expert if your child’s pain persists for over three months. At this time point, the body is expected to have healed itself and the nervous system can begin a process of hypersensitivity to pain, which is commonly seen in chronic pain.

How much of a problem is opioid addiction in the pediatric population?

Sadly, according to the U.S. Department of Health & Human Services in 2015, more than 2,000 youth between 15 to 24 years old died from opioid-related overdose. While these numbers are concerning, there has been a decrease in misuse from the opioid epidemic’s peak of use in adolescents in 2004. Given a lack of evidence to support long-term opioid use for managing chronic pain, the top chronic pain clinics are working to decrease opioid prescription.

What are some alternative methods to pain that are offered at Johns Hopkins All Children’s Hospital?

Chronic pain can be a frustrating condition for both youth and their families. While many youth feel helpless and primarily rely on medications for pain management, there is strong evidence that non-pharmacological pain management techniques can reduce pain perception and intensity. Some of the non-pharmacological methods provided or taught by physicians at Johns Hopkins All Children’s include:

  • Aromatherapy
  • Biofeedback (training the body to recognize and regulate physical symptoms of distress)
  • Meditation
  • Relaxation (e.g., Guided imagery, Progressive Muscle Relaxation)
  • Physical and Occupational Therapy
  • Psychology/Counseling
  • Self-hypnosis

Other helpful techniques for chronic pain management include:

  • Continuing everyday routines and functioning
  • Distraction
  • Exercise
  • Heat/cold application
  • Massage
  • Music, art and creative outlets

For more information on the management of chronic pain in youth, visit

Originally published in our April 2020 issue. 

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