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APPENDIX 7

EVALUATION OF YOUR CHILD'S PAIN
To aid in understanding your child's pain, make and record observations of the following factors. Report them to your doctor:

  • LOCATION OF PAIN: Be as precise as possible. Ask the child to point with one finger where it hurts the most. If it isn't in one spot, note this also.

  • SEVERITY: (How bad is the pain?) Compare it with other hurts or pains the child has experienced. Is it disabling? Does it interfere with sleep? Can the child be distracted from the pain? Is it present when the child is at rest or only when moving?

  • NATURE: (Description of the type of pain.) An older child may be able to describe the pain as burning, sharp, throbbing, cramp-like. Does the pain come and go or is it there all the time?

  • RESPONSE OF PAIN TO TREATMENT: (What relieves the pain or makes the pain worse?) Is it better or worse at rest or with moving about? Do certain positions relieve or make the child's pain worse? Is it worse with deep breathing, running, or resting? Do any drugs relieve the pain? Does a bowel movement relieve the pain?

  • ASSOCIATED SYMPTOMS: Are there any other sensations or symptoms associated with the pain, such as hunger, dizziness, cramps, diarrhea, pallor (paleness), fever, eating, eating certain foods, running, coughing, or nasal congestion?

  • TIMING OF THE PAIN: What time of the day does the child's pain occur? What days of the week? Is it related to school? Do other symptoms occur before, during or after the episode of pain? Did vomiting occur before or after or during the abdominal pain or headache? Does vomiting relieve the pain?

  • PRECIPITATING FACTOR: Is there anything that appears to bring on the child's pain? Fever, emotional upset or tension, hunger?

  • DURATION: how long does the pain last? how often do episodes of pain occur?

  • ONSET: Does the pain start suddenly or gradually? Ask the child to try to recall the exact day and time the pain began.

  • RADIATION: Does the child's pain begin at one point and spread to other areas? If so, when?

  • FAMILY HISTORY: Is there anyone at home who has recently had or is presently suffering from a similar pain? Is there a family history of similar pain?

  • WHEN THE CHILD IS BUSY OR DISTRACTED, such as watching a favorite TV show or playing a game, does the pain seem to go away or get better?
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