Traumatic Stress and Pediatric Pain: Towards a Neurobiological Stress-Health Perspective

Abstract

This theoretical review aims to present the limited findings on traumatic stress and pain in children and adolescents, highlight recent discoveries regarding neurobiological processes, and suggest an alternative stress-health perspective in the future study and conceptualization of pediatric pain and traumatic stress based on results. Current literature highlights a positive correlation between pain and trauma symptoms in youth and suggests a complex relationship that may have mutually maintaining dynamics and intertwined physiological processes. Developmentally sensitive, longitudinal, processoriented designs assessing neurobiological alterations and stress responses should be utilized in the examination of the trauma-pain relationship. Such investigations may provide a more unified explanation of the relationship between chronic pain and traumatic stress.

Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes

“…Similarly, trauma-related stress and psychological factors can amplify the experience of physical pain. Also, trauma can disrupt a child's ability to effectively cope with pain [59]. They may develop maladaptive coping strategies or engage in avoidance behaviors to deal with the pain, further perpetuating their distress and hindering their recovery [55,58].…”

“…Given these premises, in the next paragraphs, we will explore three important realms to gain a better understanding and allow us to recognize and address the relationship between trauma and pain in children more effectively. The three areas we will explore are the impact of biological memory, the critical role of the environment, and the use of models to improve our neurobiological and molecular insight [59,64,65]. A comprehensive approach that integrates trauma-informed care [58], appropriate psychological support, and pain management strategies will alleviate the impact of trauma on pain experiences and promote the child's overall well-being.…”