Pain is one of the most common problems for children and young people with CP, and managing it often requires ongoing solutions. As pain substantially affects a child’s quality of life, there needs to be a constant effort by their healthcare team and parents to support pain management.

For children and young people with CP who have cognitive difficulties, changes in behaviour should be explored as a possible symptom of a physical problem such as pain. This may include changes to their personality, facial or vocal expressions, eating and sleeping patterns.

Causes of pain for children and young people with CP include:

• painful joints or spinal deformity (scoliosis)
• increased muscle tone, spasticity (tight or stiff muscles), or dystonia (involuntary muscle contractions)
• gastrointestinal pain, such as reflux, incontinence or constipation
• routine activities, such as being lifted or daily assisted stretching
• pain caused by medical procedures
• dental pain.

The treatment will vary, depending on the reason for the pain. If you know or suspect your child is in pain, talk to your healthcare team about getting them an assessment to work out what is causing the pain. The team can then develop a plan to manage it, which may include referral to a specialist or allied health professional.

When pain is well managed, children and young people with CP can focus better on other aspects of growing up, including going to school and learning, making friends and socialising. It will also have other benefits, such as making physical therapies easier and activities more enjoyable.

Often, pain can be managed with physiotherapy and occupational therapy, using exercises that are designed to improve a child or young person’s ability to move. Active range of motion exercises have positive outcomes for pain management. Orthotic devices or adaptive equipment may be used to help stabilise limbs that are painful.

The management of pain can also include:

• different types of medications – pain relief, muscle relaxants or anti-inflammatory medication
• warmth, such as warm baths
• cold, such as ice packs
• massage to help relieve tense muscles and increase mobility
• stretching, which sometimes requires someone to help.