Pathophysiology
Clinical meaning
Children experience and express pain differently based on developmental stage. Neonates and infants have fully functional pain pathways but limited ability to communicate — they express pain through crying, facial grimacing, body rigidity, and changes in vital signs. Descending inhibitory pain pathways are immature in neonates, meaning they may experience pain more intensely than older children and adults. Age-appropriate pain assessment tools are essential: FLACC scale (Face, Legs, Activity, Cry, Consolability) for ages 0-7 or nonverbal patients, Wong-Baker FACES scale for ages 3-7 (self-report using facial expressions), and numeric rating scale (NRS 0-10) for children ≥ 8 years who understand number concepts.