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Pain in children

Assessing pain

Pain is different for everyone. There are differen​t ways to measure—or assess—your child's pain so you know how bad it is.

Assessing pain depends on the type of pain your child has, as well as their body, age, stage of development, life experiences, and cause of their pain.​​​

Babies​ and toddlers

Babies and toddlers don’t have the words to tell you about their pain. But they may show you by doing things such as making faces, kicking their legs, being cranky, crying, or having tense muscles.

To assess pain in babies and toddlers, your healthcare provider may use the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. It uses your child’s behaviour to measure their pain.

If your toddler speaks and understands a few words, you can use words they understand (“boo boo” or “ouchie”) and ask simple questions such as “Does your arm hurt?”

School-aged children

Along with asking a school-aged child about their pain, you and your healthcare provider can use a tool called the Faces Pain Scale-Revised.

This tool shows 6 different faces for your child to choose from. The faces range from a happy face (no pain) to a very upset face (worst pain ever). The face your child chooses helps you understand how much pain they are feeling.

Older children and teens

Older children and teens can tell you about their pain. Ask your child to rate their pain from 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine.

You can also use the Stoplight Pain Scale to help you decide what to do about your child’s pain:

  • Red: “My pain is very bad, and I need help now.”
  • Yellow: “I may need help for my pain soon—ask me again later.”
  • Green: “I don’t need help with my pain right now.”

©2014 Booster Shot Media, Inc. and Amy Drendel, DO. The Spotlight Pain Scale™ can be reused under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Nonverbal children

Children who are nonverbal (do not speak) or have cognitive (learning) issues may need to tell you about their pain in their own way. You know your child best and are the best person to measure your child’s pain.

Look for any changes in the sounds or facial expressions your child makes, things they do, and anything that seems different with their body.

Healthcare providers may also use a type of Faces, Legs, Activity, Cry, Consolability (FLACC) scale to assess pain in a nonverbal child.

Assessing chronic pain

You need more than tools to assess chronic (long-term) pain. It’s important to watch your child’s symptoms and notice how they are feeling over time. This will help healthcare providers to know what is affecting your child’s pain, how much pain they have, and offer ways to manage it.

Talk to your healthcare provider about how chronic pain is affecting or changing your child’s:

  • daily activities
  • grades or behaviour at school
  • mood and mental health
  • appetite
  • sleep
  • relationships with family and friends

Learn more

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