Is your child often complaining of a sore tummy? Does it interfere with their eating, sleeping, or ability to attend school? If so, you’re not alone. Chronic abdominal pain is one of the most common types of persistent pain in children and adolescents - and it can be both distressing and frustrating for families to manage.
Many parents experience a situation where they have taken their child to the doctor and have had multiple tests with results that are all normal. They are then often told that “it’s just a phase”, “it’s all in their head”, that their child is “looking for attention” or that they will “grow out of it”. But the reality is: chronic pain is real, even when medical tests don’t show a clear cause. And importantly, it is treatable.
At our Paediatric Chronic Pain Service, we specialise in supporting children aged 0–16 living with chronic pain, including functional abdominal pain, through a compassionate and evidence-based team approach.
What Is Chronic Abdominal Pain?
Chronic abdominal pain is generally defined as pain that has lasted for more than two months, and which occurs regularly enough to affect a child’s daily life. Sometimes the pain is linked to eating, toileting, or anxiety—other times it seems to come from nowhere. In many cases, routine investigations such as blood tests and scans may come back normal, which can make the experience even more confusing and invalidating for families.
This kind of pain is often referred to as functional abdominal pain, meaning there’s no obvious structural or disease-based cause—but the pain is very real and impacts quality of life.
Why the Biopsychosocial Model Matters
Research over the past two decades has made it clear: chronic pain is not just physical. It arises from a combination of biological, psychological, and social or environmental factors—a model known as the biopsychosocial approach to pain.
Let’s break it down:
🧬 Biological Factors
- Genetic predisposition to pain or having a more sensitive nervous system
- Past infections, surgeries or gut diseases or disturbances
- Changes in gut-brain communication (especially in young children)
🧠 Psychological Factors
- Stress, anxiety, or trauma
- Perfectionism or performance pressure
- Fear of the pain itself, creating a cycle of worry and physical symptoms
🏡 Social/Environmental Factors
- School or other demands, bullying, or social challenges
- Family dynamics or routines
- Sleep issues, eating habits, or activity levels
Together, these factors can amplify the way the nervous system processes signals from the gut—meaning that even normal digestive activity can feel painful.
Understanding and treating all of these dimensions is key to helping your child recover.
When Should Parents Seek Help?
It’s important to seek a comprehensive assessment if your child’s abdominal pain is:
- Frequent or long-lasting (more than a few weeks)
- Disrupting daily life (school, sleep, appetite, social activities)
- Not improving with simple lifestyle changes
- Associated with emotional distress like anxiety or avoidance behaviour
While some red flags (signs of serious underlying conditions) — such as unexplained weight loss, blood in stools, severe vomiting, or pain that wakes the child at night—need urgent medical evaluation, most chronic abdominal pain in children is not dangerous. But that doesn’t mean it should be ignored.
Pain is never “just in their head”. It’s real, and it deserves treatment.
Could It Be Something Else? Other Causes to Consider
Not all abdominal pain originates in the gut itself. In some children, especially older children and adolescents, pain felt in the stomach may be “referred pain”— this means the pain comes from another structure or system in the body, but is felt in the abdominal area.
Some common examples include:
🦴 Referred Musculoskeletal Pain
- Tension in the lower back, hips, or pelvis—especially if there’s poor posture or inactivity—can sometimes cause discomfort that is perceived as abdominal pain.
- Children involved in high-impact sports or who have had a recent growth spurt may develop musculoskeletal issues that cause pain in the abdomen, pelvis, or flank.
♀️ Dysmenorrhoea (Painful Periods)
In adolescent girls, period pain can be a major contributor to chronic abdominal pain, particularly if the pain begins before or extends well beyond menstruation. Importantly, this is not ‘just the way things are’, and doesn’t have to interfere with daily life. Treatment is available and should be provided.
- Sometimes girls experience severe cramps, nausea, or fatigue related to their cycle - yet it may not always be immediately linked to periods.
- Dysmenorrhoea can sometimes co-exist with functional pain, migraine, anxiety, or hormonal sensitivities, making symptoms feel more intense and persistent.
- It's important to assess whether period-related pain is interfering with school, sleep, or emotional wellbeing, as there are many effective management options available.
Understanding whether abdominal pain might be referred from other systems—or influenced by the menstrual cycle—is a key part of the assessment we offer through our Paediatric Chronic Pain Service. A thorough, multidisciplinary evaluation ensures that no possible contributing factor is overlooked.
How Is Chronic Abdominal Pain Treated?
Best practice shows that multimodal care, which addresses all parts of a child’s experience—not just their symptoms—is the most effective way to treat chronic abdominal pain.
At our Paediatric Chronic Pain Service, we take this whole-child approach seriously. Our team includes:
👩⚕️ A Paediatrician with Special Interest in Chronic Pain
The paediatrician rules out serious medical causes, manages medication (if needed), and leads the diagnostic process.
👩🔧 Occupational Therapists (OTs)
Our OTs support children in regaining function—helping them return to school, play, and daily routines. They also act as care coordinators, making sure communication is seamless across the whole team.
🧠 Psychologists
Many children benefit from therapeutic approaches such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), play therapy, narrative therapy or trauma-informed support. These approaches help children understand their pain, build confidence, and reduce fear-based avoidance.
🏃♂️ Physiotherapists
Physiotherapists gently guide children to move safely and confidently again. For children with abdominal pain, this can include core strengthening, relaxation exercises, or posture and breathing strategies.
👨👩👧 Social Workers
Family stress can impact pain recovery. Our social workers help parents, caregivers, and siblings navigate the emotional and practical impact of chronic pain—because treating the whole family is often necessary for the child to improve.
What to Expect from PAINService
Our service begins with a joint consultation between the paediatrician and occupational therapist, giving you a comprehensive first assessment without needing to repeat your story multiple times. Together, we create a plan tailored to your child’s unique needs.
We then refer to other team members as needed, based on collaborative decision-making that includes you and your child.
Our guiding principle is to:
- Identify the most treatable aspect of the pain
- Make the biggest difference in the shortest time
- Keep care accessible and affordable
We charge 100% medical aid rates and accept privately funded patients. If you’re worried about costs, we’re happy to chat about payment options.
Most importantly—you don’t need a referral. Parents are welcome to self-refer directly.
Chronic Pain Affects the Whole Family—But Recovery Is Possible
Chronic abdominal pain doesn’t just affect your child’s body—it affects their emotions, confidence, school performance, social life, and your entire household. But with the right support, most children can return to full, happy participation in life.
At our Paediatric Chronic Pain Service, we believe in restoring function—not just reducing symptoms. And we’re here to help you and your child navigate this journey with compassion, clarity, and expert care.
📞 Need Help?
You can book your child’s first appointment by calling our central booking number. No referral needed.
Let’s work together to help your child get back to doing what they love—without pain holding them back.