Chronic pain – a descriptor of pain that has been ongoing for a longer period or recurring in nature – is a common occurrence in childhood, with data showing 1 in 5 children experiencing pain of some description in their lives. The issue with this is pain can significantly impact children’s academic performance, with research showing a clear link between pain and reduced school functioning. Children experiencing chronic pain are 4.2 times more likely to be chronically absent from school compared to their pain-free peers. This high absenteeism often leads to lower academic achievement, with 44.3% of parents reporting a decline in their children’s grades since the onset of pain.
The academic struggles extend beyond attendance issues.
– 40% increased likelihood of poor school engagement
– 90% higher chance of school-related problems
– 1.6 times more likely to be diagnosed with a learning disability
The most common reason for this chronic pain? Headaches.
Headaches are a common form of chronic pain in children and can be particularly disruptive to academic performance. They can impair concentration, reduce cognitive function, and lead to increased school absences – which further impacts on grades and academic performance through stress of falling behind or not being taught material. However, for children suffering headaches, manual therapy has shown some promise as a treatment option.
Recent evidence suggests that manual therapy may be effective in reducing headache intensity, frequency, and associated disability in the short and long term. A systematic review and meta-analysis in 2022 found moderate-to-large effects favouring manual therapy for reducing headache frequency and intensity in the short term. A randomised clinical trial in 2021 looked into the difference in response between manual therapy and a sham treatment, and stated “the positive results from this study combined with the low risk of adverse events should encourage clinicians and policy-makers to consider spinal manipulation for children with recurrent headaches”.
Is your child experiencing headaches or chronic discomfort? It might be worth having a chat and seeing how we may be able to help!
REFERENCES
Adachi, K., Sakai, N., Kimpara, K., & Arizono, S. (2024). The effect of physical therapy integrated with pharmacotherapy on tension-type headache and migraine in children and adolescents. BMC Neurology, 24(1), 1–15.
Bini, P., Hohenschurz-Schmidt, D., Masullo, V., Pitt, D., & Draper-Rodi, J. (2022). The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis. Chiropractic & Manual Therapies, 30(1).
Groenewald, C. B., Giles, M., & Palermo, T. M. (2019). School absence associated with childhood pain in the United States. The Clinical Journal of Pain, 35(6), 525.
Groenewald, C. B., Tham, S. W., & Palermo, T. M. (2020). Impaired school functioning in children with chronic pain: A national perspective. The Clinical Journal of Pain, 36(9), 693.
Kosola, S. K., Mundy, L. K., Sawyer, S. M., Canterford, L., Van Der Windt, D. A., Dunn, K. M., & Patton, G. C. (2016). Pain and learning in Australian primary school students. European Journal of Public Health, 26(suppl_1).
Lynge, S., Dissing, K. B., Vach, W., Christensen, H. W., & Hestbaek, L. (2021). Effectiveness of chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7–14 years – a randomised clinical trial. Chiropractic & Manual Therapies, 29(1), 1.
Norton, J., & Southon, N. (2021). Exploring the Prevalence of Pediatric Chronic Pain and School Absenteeism for Therapists Working in Schools: A Systematic Review with Meta-Analysis. Physical & Occupational Therapy in Pediatrics, 41(3), 227–243.
Odendaal, T., Diener, I., Louw, Q. A., & Ernstzen, D. V. (2025). The Concept of Pain in Children Attending Primary School: Implications for School-Based Pain Education. Pain Research and Management, 2025(1), 3198988.