Six children in every classroom experience chronic pain. Compared to their peers, young people who experience chronic pain are more likely to be physically inactive, experience poor mental health, engage in substance use, be bullied, and miss out on school. They are also more likely to continue experiencing chronic, impactful pain as an adult.
“I cried a lot during that time, and I was missing being active because I couldn’t really even go for walks or anything, and so I just missed doing anything really.”
[15-year-old female after injury]
“It was a bit annoying when you go to all of the games and you see your mates, that they’re having a blast, and you think, you know, ‘I could have been there, that could have been me.’
[12-year-old male after injury]
In 2021, the Commonwealth Government endorsed the National Strategic Action Plan for Pain Management, one of the key recommendations was to develop and deliver a pain education program in schools. School-based health education equips young people with the skills to make informed decisions about their health during adolescence and throughout their life. But unlike other important health conditions that affect young people such as mental health, substance use and sexually transmitted infections, there are no well-resourced education programs about pain in schools.
We believe pain education in schools is important to prepare young people for a healthy future.
What is chronic pain and why does it matter?
Chronic pain is pain that persists for periods of 3 months or more or that repeatedly comes back and has an impact on day-to-day life. Chronic pain can result from injury, musculoskeletal conditions such as arthritis, or other health conditions such as endometriosis or migraines. Sometimes, it is not possible to identify a clear cause for chronic pain.
Chronic pain affects 1 in 5 Australians. Musculoskeletal conditions (that affect joints, bones and muscles) are among the costliest health issues in Australia. They represent the third-highest annual healthcare expenditure, following Cancer and Cardiovascular disease, and they are more expensive than mental health and substance use disorders for the public health system.
Why does teaching young people about pain at school matter?
Historically, pain was understood through a ‘biomedical’ lens, where pain indicated tissue damage (injury). The biomedical explanation does not explain why pain often persists for months or years. These outdated beliefs about pain are still common, and young people often receive incorrect information and support for pain. Embedding pain education in schools will ensure all young people have access to current, evidence-based information about pain. Contemporary understanding of pain positions it as a bio-psycho-social experience, analogous to the dimensions of health model already taught in the PDHPE curriculum. The bio-psycho-social model describes how biological, psychological and social factors influence, and are influenced by pain. Teaching students about the bio-psycho-social model of pain can empower students to understand and manage pain during adolescence and potentially change the trajectory of persisting pain in adulthood.
Young people with pain often feel unsupported and misunderstood by their peers and teachers due to perceptions they are ‘faking’ or ‘exaggerating’ their pain for attention. This can affect their school attendance, academic performance, and reduce their sense of belonging at school. Increasing awareness about pain through education can lead to a more inclusive and supportive school environment for students experiencing pain. Stigmatising beliefs regarding people with pain may be underpinned by misconceptions about what pain actually is.
“I had a lot of absent days, more so because of pain than being sick. I had to stay home from school because I couldn’t handle school… They [my classmates] were always just questioning why I was sitting out of class, or why my eyes would go watery sometimes. And they just didn’t know how much pain I was in really, or the cause of it, or why I was sitting out. They thought I was just trying to bludge class. Some were more like ‘Oh, you’re being over-dramatic’.”
[15-year-old female with chronic pain]
How to educate young people about pain at school?
The Pain Smart education module consists of three ready-to-teach lessons about pain and pain management. Designed with input from adolescents, teachers, health professionals, and researchers, the lessons are interactive, aligned with the NSW PDHPE curriculum (current and new) and reflect current scientific evidence about pain. Schools can decide when it is best for them to deliver the education module, and we will fit the study processes around that preference.
“The lessons had a variety of activities, for example case studies, note taking, discussion, brainstorming. The student worksheets were a good resource and effective and easy for students to complete.”
[Year 10 PDHPE teacher at a pilot school]
Interested in becoming a Pain Smart school?
We are partnering with secondary schools across NSW to offer the Pain Smart education module for delivery to students in years 7-10. We will evaluate the education module in a large randomised controlled trial. Schools participating in the trial will receive the Pain Smart education module, teacher training, parent resources, $1000 payment to recompense staff time, and a summary report about their participating students’ health and wellbeing. Participating students will go into a draw for a $50 gift card in each class. The research is funded by the Commonwealth Government and approved by the Human Research Ethics Committee of University of Sydney (2024_HE001772).
If you are interested in your school becoming a Pain Smart school or just want to know more, express your interest online, here: https://redcap.sydney.edu.au/surveys/painsmarteoi or by scanning the QR code. We will be in touch to discuss Pain Smart for your school. There is no initial commitment required, and we will ensure the process is as smooth as possible. Alternatively, contact the Pain Smart team directly via email pain-smart.study@sydney.edu.au or phone +61 468 385 128.You can also visit our website to learn more about the study and read some of our published work: https://painsmart-education.sydney.edu.au/.
Who we are
The Pain Smart project is run by a group of health researchers based at the University of Sydney and affiliated with Nepean Blue Mountains Local Health District. The team is led by Professor Steve Kamper, who has published over 200 peer-reviewed articles, most on the topic of pain in adults and children. Dr Tie Yamato is the study coordinator, and is an internationally recognised researcher in the field of adolescent pain. Isabelle Bogard is a Physiotherapist in the chronic pain service at Nepean Hospital, Payton Soussa and Sarah Kilgour are Clinical Psychologists at Children’s Hospital Westmead, all three are doing their PhDs in the Pain Smart program. The team is supported by Dr Laura Montgomery who is a Chiropractor and Research Fellow at USyd. The Pain Smart trial is funded by a $1.2 million grant from the Medical Research Future Fund of Australia and is a collaboration between Australian and international researchers, educators, and adolescents. Further information is available at https://painsmart-education.sydney.edu.au/
