When Pain Gets in the Way: What Parents Should Know

School is a big part of a child’s life, not just for academics but also for social connections, daily routines, and confidence-building. For some children and teens living with chronic pain, school can quickly become a major source of stress. Pain can make it hard to focus, sit through class, or get through the day.

If your child has chronic pain, you’ve likely seen how difficult it can be to maintain school attendance and keep up with expectations. What many families don’t realize is the role pain-related thoughts and emotions also play. Just as importantly, how you respond to your child’s pain matters too.

What Is Chronic Pain and How Does It Disrupt School?

Chronic pain refers to pain lasting longer than three months. Chronic pain is relatively common as it affects up to 1 in 5 youth.

When pain is unpredictable or persistent, everyday school experiences (getting ready in the morning, sitting through class, completing assignments) can feel overwhelming. Nearly half of children with chronic pain miss about 25% of all school days. These absences can be frustrating and cause a chain reaction: falling behind academically, feeling disconnected from peers, and increased stress, which in turn can worsen pain. Over time, poor school functioning can impact self-esteem, parent-child relationships, and even future outcomes like college or career readiness.

What Is Pain Catastrophizing?

“Pain catastrophizing” describes a pattern of negative thoughts and feelings about pain. Kids (and adults!) who catastrophize may:

• Focus on pain constantly (“I can’t stop thinking about how much this hurts”)
• Worry the pain is dangerous or permanent
• Feel helpless (“Nothing I do will help”)
• Expect the worst (“This pain will ruin my whole day”)
• Avoid activities (like school) out of fear the pain will get worse

These thoughts are common and understandable, but when left unaddressed these thoughts can make pain feel worse and interfere with daily functioning.

Parents Catastrophize, Too

Parents can also experience catastrophizing thoughts about their child’s pain.

For example:

• “If I send them to school like this, they’ll just get worse.”
• “There’s no way they can get through a full school day.”
• “If I push them too hard, I’ll make it worse.”

These thoughts often come from love and concern. But research shows when parents focus on worst-case scenarios, they may unintentionally reinforce school avoidance by becoming overly protective or lowering expectations for their child.

How to Support Your Child’s School Success, Even with Pain

Helping your child re-engage with school, even gradually, can make a big difference. Here are some strategies:

Do:

• Encourage consistent routines (e.g., getting up, getting dressed).
• Validate the pain but also remind your child they can do hard things.
• Work with the school on a plan (e.g., modifying the school day, reduced workload).
• Encourage practice of coping skills like deep breathing, activity pacing, or short stretch breaks.

Try to avoid:

• Letting pain determine school attendance.
• Assuming absence is the safest option.
• Ignoring your own anxiety about your child’s pain.

Chronic pain is real and it’s tough, but there are tools that can help. Research shows how children and parents think about pain can influence school attendance, performance, and long-term success.

By understanding pain-related thought patterns (like catastrophizing) and building supportive routines, families can break the cycle of school avoidance and help their children feel more confident, capable, and connected, both in and out of the classroom.