Understanding the management of the child with pain.

Pain experienced by the child or perceived by the child's parents generally results in the child being taken forthwith to the doctor. Often the cause of the pain is obvious, such as an injury or an "acute" abdomen, and resolution may be readily achieved with the aid of medical science, the concern of the doctor, and the dedication of the parents. However, there are situations in which, despite the full resources of the physician and other helping professionals, resolution of the child's pain may not be forthcoming. This can particularly be observed in infants and children who are at risk and may have injuries inflicted by the persons looking after them. Infants and children may experience, or are thought to experience, pain in a recurrent and often troublesome way. Yet physical examination often reveals no abnormalities and further investigation is unhelpful. Resolution of the pain requires an understanding of the meaning of the pain to the child and its significance within the family. The clinical features of this kind of pain are described to highlight those aspects which may be helpful in its resolution.