Is There a Link Between Parental Chronic Pain and Their Child's Pain?

The living situation may be a major influence

Is Your Child More Likely To Have Pain If You Do?
Is Your Child More Likely To Have Pain If You Do?. Getty Images

If you have chronic pain, does this influence whether your child also has chronic pain? This is a complex question, and the research on whether such a link exists is mixed.

To explore this potential connection further, experts started digging deeper into the parent-child relationship.

One factor they uncovered as playing a potential role in influencing the link between a parent's chronic pain and their child's chronic pain is the family structure (in other words, their living situation).

This was discovered by investigators of a large Norwegian study in Jama Pediatrics.

Defining Chronic Pain

The authors of the study in Jama Pediatrics defined "chronic nonspecific pain" in the teenage offspring population as pain occurring at least once a week for three months.

"Chronic multisite pain" was defined as chronic nonspecific pain that occurred in at least three locations within the body (for example, the abdomen, back, and head).

For adults, chronic pain was defined as pain that occurred for more than six months (this is a standard definition).

The Effect of Parental Pain on Their Teenage Children

In the study, over 7000 adolescents and young adults (ages 13 to 18) filled out a questionnaire regarding pain. The questionnaire specifically inquired whether they had experienced any pain within the past three months and how often (for example, "seldom," "once a week," or "almost daily").

Then, over forty thousand adults completed a questionnaire answering these questions:

  • "Do you have physical pain now that has lasted more than 6 months?"
  • "How strong has your physical pain been during the last 4 weeks?" (answers were either no pain, very mild, mild, moderate, strong, or very strong)

Since the study took place in Norway, the questionnaires from the adolescents and young adults could be linked to their parent's questionnaires through personal identification numbers (everyone in Norway has one).

After linking parents with their children, the investigators were left with over 5300 adolescents or young adults who had at least one parent who had also participated in the questionnaire.

When analyzing the questionnaires in both the parents and their teenage children, it was found that chronic pain in either the mother or father was associated with chronic nonspecific and chronic multisite pain in their children. The odds of this pain in children were even higher when both the mother and father reported pain.

These associations remained the same even with the study investigators controlled for the variables like  gender, age, and socioeconomic status.

What Does This Mean?

The above results suggest that a strong link exists between a parent's chronic pain and the chronic pain of their teenage children.

Why? Possibly, a parent with chronic pain gives children more exposure to pain behaviors, making them more attune to and/or focused on painful physical symptoms. Another thought is that a parent with chronic pain may give a child more attention for pain-related symptoms or be more overprotective, which can influence, even possibly reinforce, a child's pain experience.

In addition, the fact that the odds of having chronic pain are higher when both parents have chronic pain versus one parent (or no parent) could indicate a sign of distress in the family, reports the study authors.

In other words, possibly outside stressors are causing familial dysfunction, which is causing multiple family members to report chronic pain.

Family Structure May Be a Factor in Linking Parental to Child Chronic Pain

In addition to examining the link between parental and offspring pain, the investigators also examined a variable that may influence this link: the family structure (living situation).

The study found that the prevalence of pain in the adolescents and young adults was reduced among those who lived with both parents, as opposed to one parent.

In addition, of the adolescents and young adults living primarily with their mother, their odds of having chronic pain was more likely if their mother had chronic pain.

The odds of chronic multisite pain (meaning pain in 3 or more areas of the body) were even greater if the teenage children lived primarily with their mother and a new partner of their mother, versus just their mother alone.

On the other hand, if the teenage children lived primarily with their father (or their father and a new partner), their odds of having pain were increased when either their mother or father had chronic pain, although the link between having pain in multiple sites in the offspring was more strongly linked to the father's chronic pain.

Overall, this study reinforces the environmental aspect of chronic pain, especially in children. In other words, not just biological factors are at play when it comes to the experience of chronic pain, but psychosocial ones as well—like who a child lives with and interacts with on a daily basis.

Other Interesting Points in the Study

The study also found that more female children and more mothers had chronic pain than male children or fathers. This suggests a gender difference exists among teenagers and adults reporting pain.

In addition, children who had anxiety and depression symptoms were more likely to have chronic pain, as were their parents. This is a common finding, and it's often unclear what came first, the pain or the anxiety/depression—a chicken versus egg conundrum. Often the pain and the psychiatric symptoms feed off one another creating a vicious cycle.

Finally, chronic pain reporting decreased in both mothers and fathers, as education and income level increased. Like the family structure, this supports the role of environmental factors in modulating chronic pain.

A Word From Verywell

This study not only supports the multifaceted nature of chronic pain in adolescents and young adults but also suggests that when treating chronic pain in children, the family environment needs to be taken into account.

If you have a child who has chronic pain, the take home point for you as a parent is to consider how your family may be used as a positive tool in helping your child cope better with his or her pain.  Of course, do not carry this burden alone—talk with your child's doctor and pain healthcare team.

Sources:

American Pain Society. (January 2012). Assessment and Management of Children with Chronic Pain.

Hoftun GB, Romundstad PR, Rygg M. Association of parental chronic pain with chronic pain in the adolescent and young adult: family linkage data from the HUNT study. JAMA Pediatr. 2013 Jan;167(1):61-9.

Palermo TM, Holley AL. The importance of family environment in pediatric chronic pain. JAMA Pediatr. 2013 Jan;167(1):93-94.

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