Pain in the Child with Sickle Cell Disease

Painful Episodes in the Child with Sickle Cell Disease 

Painful episodes occur in children with sickle cell disease as a complication of the disease. These episodes more commonly occur in older children, but often happen in infants and young children.  

What Causes the Painful Episodes?

The exact cause of the pain is not known. It is thought that the red blood cells (RBC's) become trapped inside a blood vessel and interfere with normal blood flow. If blood flow is reduced in even a small area of the body, it can cause pain.

Sometimes swelling is seen in the area of the pain. In children under 2 years of age, the swelling usually occurs in the hands and/or feet. Older children can have swelling in the arms and/or legs. Swelling usually does not mean that something is seriously wrong, but in rare cases, swelling and pain are caused by infection in the bone. A child with swelling other than hands and feet should be seen by a doctor.

Where is the Pain?

Most often the pain seems to be in the bone, but it can occur anywhere in the body (chest, stomach, hands and/or feet, back, etc.) These painful episodes are not usually dangerous. They can last for several hours, days or even up to a week or two.

What Can Be Done to Ease the Pain?

Painful episodes can be mild, moderate or severe in terms of how much it hurts your child. Discomfort is usually relieved by taking medication for pain and drinking plenty of liquids. A child may refuse to use the part of the body that is painful. If a child will not stand or walk or move a part of his body that is painful, do not force him to do so. As soon as the pain is better, they will be active again. To ease the pain, your doctor may recommend giving Acetaminophen (Tylenol) every 4 hours.

If your child is still uncomfortable after receiving the Tylenol, your doctor may prescribe them other pain medications.