Understanding referred pain in children

Kids-Referred-PainHave you ever watched a TV show where someone who’s having a heart attack grabs his left arm or shoulder? Have you ever had a stabbing pain in your forehead or the bridge of your nose after eating ice cream too quickly? With a heart attack, the source of the pain is in the person’s chest. With a brain freeze, the source of the pain is in the roof of your mouth.

Referred pain occurs because the body’s sensory nerves occasionally send signals in the wrong direction. The following examples commonly occur in children:

  • When children complain of mouth, cheek or tooth pain, they sometimes have an ear infection.
  • When children complain of ear pain, they sometimes have a throat or lymph node infection in their neck.
  • When children complain of knee pain, they sometimes have a problem in their hip or testicle.
  • When children complain of low back pain, they sometimes have constipation.
  • When children complain of stomach pain in the middle of the night, they sometimes have a pinworm infection.
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The difference between pain and tenderness

Michael Pramenko Jack PerrinPatients are sometimes confused when doctors differentiate the terms pain and tenderness. The reason we use these words differently is because they mean different things when it comes to making a diagnosis. If something is painful, that means it hurts. If something is tender, that means it hurts when it is touched or moved. A good example of how we use these terms relates to abdominal pain. I could have a horrible stomachache, but if it doesn’t hurt more when someone pushes on my abdomen, I am not tender. Appendicitis always causes a tender abdomen. Similarly, migraine headaches cause severe pain in addition to nausea and photophobia (it hurts to look at lights), but patients with migraine usually don’t have scalp tenderness. If someone has a bad headache associated with scalp tenderness, it’s often due to muscle tension that’s brought on by psychological or physical stress such as carrying a heavy backpack or keyboarding for long periods of time.