Research Recap with Skye: Childhood pain and ADHD
Welcome to Hacking Your ADHD. I’m your host, William Curb, and today I’m joined by Skye Waterson for our research recap series. We’re diving into a paper titled "Pain Associated Diagnosis in Childhood Before the Diagnosis of ADHD." We want to see if kids who were eventually diagnosed with ADHD showed higher rates of pain-related medical visits before that diagnosis even happened. This is a vital question because about a quarter of chronic pain patients are also diagnosed with ADHD.
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William: Welcome to Hacking Your ADHD. I’m your host, William Curb, and today I’m joined by Skye Waterson for our research recap series. We’re diving into a paper titled "Pain Associated Diagnosis in Childhood Before the Diagnosis of ADHD." We want to see if kids who were eventually diagnosed with ADHD showed higher rates of pain-related medical visits before that diagnosis even happened. This is a vital question because about a quarter of chronic pain patients are also diagnosed with ADHD.
Skye: This paper is fascinating because it looks at a wide variety of pain—headaches, musculoskeletal pain, tension headaches—specifically in kids. It was a population-based case-control study, so it included a huge number of people to see if those later diagnosed with ADHD were seeking more medication or support for pain early on.
William: Right, they initially looked at over 700,000 people. They eventually narrowed it down to almost 19,000 children diagnosed with ADHD and a control group of 37,000 who were not.
Skye: It was a massive study. It gave them enough data to really tease out different experiences of pain. While I haven't personally experienced chronic pain, it’s clearly very common in the ADHD community.
William: They also had to control for variables like socioeconomic status, since you're more likely to seek treatment if your parents can afford it. The study was conducted in Israel, so while the population was somewhat homogeneous, they still controlled for ethnic and religious backgrounds to see how upbringing might change the likelihood of seeking treatment.
Skye: To give you an idea of what they tracked: they looked at headaches, migraines, eye pain, ear, throat, and abdominal pain, as well as joint pain and sprains. Sprains are particularly interesting since you see those often in kids who are active or prone to falling. So, what did they actually find?
William: The numbers were significant. They found a 50% higher likelihood for headaches and a 30% higher likelihood for ear pain. Every category showed some level of increased need for pain management. It’s an important caveat: the study doesn't necessarily prove these kids experience more pain, but they required more pain management. If they’re getting treatment or over-the-counter meds, it implies there's a higher level of pain occurring.
Skye: Exactly. They found statistically significant associations and clinically meaningful effect sizes. Children later diagnosed with ADHD had a 14% higher occurrence of abdominal pain, 35% more limb pain, and 40% more joint pain. What makes this study special is that these visits happened before the ADHD diagnosis. Usually, people might claim a diagnosis makes someone "think" they have more symptoms, but these kids didn't even know they had ADHD yet.
William: That’s a great point. It also touches on how people with chronic pain are often ignored because, unless there's a visible wound, it’s hard to prove something is wrong.
Skye: It’s so subjective. People often assume a child is just acting out for attention, but this data shows a consistent need for medical management. It makes you wonder about the interplay—there are theories about neurodevelopmental changes or neuroinflammation being a common denominator for both ADHD and altered pain perception.
William: Since ADHD is neurodevelopmental, the way the brain develops might predict how the rest of the body develops or processes sensations. We might simply be more sensitive to pain.
Skye: The paper doesn't definitively say why it’s happening or which comes first, but the connection is there.
William: I’d also bet on sensory issues. It’s harder for ADHD brains to filter out incoming sensory information. For us, pain stays at the forefront of the mind; we can't ignore it the way a neurotypical person might.
Skye: True, except in cases of hyperfocus where you might sprain an ankle and not notice until later! There’s also the question of whether chronic pain in childhood makes it harder to focus, which then looks like ADHD. A good clinical diagnosis should rule that out, but it's a conversation worth having.
William: Then there’s the impulsivity factor. If you're constantly damaging yourself as a kid, those injuries last. I’ve had a shoulder separation, five or six dislocations, a torn quad, and ankle injuries so bad they chipped the bone. Many of those were likely due to being impulsive.
Skye: It’s a complicated, subjective relationship. We wanted to bring this up because most people aren't scrolling academic papers all day. This might be the start of a journey for someone to look into their own history more deeply.
William: It shows that kids with ADHD who complain of pain aren't just being dramatic. Frequent pain could even be a "red flag" for a future ADHD diagnosis. Whether it’s sensory, emotional—since we experience emotions more strongly—or related to sleep disruption, there is a lot here to investigate. It helps explain why some kids might be seen as "distractible" or "irritable" when they're actually just in pain.
Skye: 100%. Hopefully, this is a helpful starting point for a lot of people.