Helping children conquer their chronic pain

Oct. 31, 2025

By Siska Lyssens

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For Kara Davis, the difference between her seventh grade self and who she is today at age 19 is night and day. Growing up, chronic stomach pain kept her home from school and made her miss out on having fun with friends and family. “Before, I was living a bogged-down black-and-white life,” she says, looking back on a childhood marked by crippling stomach issues. “Now, I’m at the light at the end of the tunnel.”

“It’s difficult seeing your kid in pain,” says Kara’s mom, Sondra Davis. Kara would often get in trouble at school for missing so many days, and Sondra just wanted to help her daughter find relief.

Hope for a solution came when the Davises found out about a Michigan State University study supported by a federal grant from the National Institutes of Health, or NIH. It offered access to simple pain management tools that would soon prove to be life-changing for Kara — as well as promising treatments for children who struggle with chronic pain.

Developed by Natoshia Cunningham, an associate professor of family medicine in the MSU College of Human Medicine who leads a lab that studies pediatric pain, the study followed a six-session program that includes both in-person therapy sessions and online self-management tools. The program, called ADAPT, short for Aim to Decrease Anxiety and Pain Treatment, uses cognitive behavioral therapy, or CBT, to teach children with abdominal pain disorders strategies to manage their symptoms. Over the course of her career, Cunningham has received multiple NIH grants to develop and test ADAPT. In the NIH-funded study Kara participated in, Cunningham used neuroimaging techniques to understand how children’s brains change after access to this effective intervention.

The lasting effects of this treatment have been transformational for both mother and daughter. Today, Kara is thriving in college — with dreams of becoming a news anchor — and enjoying life as a typical young adult. For Sondra, knowing that there are tools that can help her child manage her symptoms has been empowering. Feeling hopeful about the future in a way that she never felt before, Kara beams as she says, “I could not imagine doing the rest of my life without this study. It just made the biggest impact ever.”

From pain to power

Despite the assumption that childhood is a time when the body functions at its best, chronic pain in children is not rare: about one in four children and teenagers suffers from a chronic pain condition. Some have persistent symptoms that can carry through to adulthood, leading to negative outcomes such as lower academic achievement, increased risk of substance use and depression.

Kara experienced one of the most common chronic pain conditions of childhood, known as functional abdominal pain disorders, which include conditions such as irritable bowel syndrome. Many children who suffer see various medical providers and undergo extensive medical testing before getting a diagnosis. The need to rule out other medical conditions first often delays diagnosis and, as a result, also delays access to effective care. Through her research, Cunningham found that ADAPT was more effective in improving pain-related outcomes and anxiety for children with functional abdominal pain compared to standard medical care. Cunningham partnered with collaborators at Corewell Health/Helen DeVos Children’s Hospital to enroll people like Kara into an NIH-funded study to understand how children experiencing chronic pain could find relief through a program like ADAPT.

Kara points to a few CBT skills from this program that she still uses today. For example, before stressful events like a test, she practices relaxation strategies, such as tensing and relaxing her muscles. She also listens to a voice memo her therapist created, which helps her fall asleep when stomach pain keeps her up at night. Kara says that having a toolbox of techniques is the biggest benefit of ADAPT treatment. “Just having ways out really helped me take my life back.”

Turning research into accessible care

Cunningham, who trained in pediatric pain psychology, has found that treating physical pain with tailored psychological care improves outcomes for children. Not only can they go back to doing things they need and want to do, like taking part in school and social activities, but they also need less help in the long term. The cognitive behavioral skills children build help them manage both the pain and the anxiety that makes pain symptoms worse, which reduces their reliance on the health care system. The program’s strategies positively impact parents’ anxiety and stress levels, too.

Another thing Cunningham has learned is that scientific studies and their findings don’t always reach the people who could benefit most — much less become a part of their actual care. To change that, she brings her work into schools and medical settings, helping ensure that the treatments she develops can reach families who might otherwise not have access to such programs.

I could not imagine doing the rest of my life without this study. It just made the biggest impact ever. — Kara Davis

To reach more children, Cunningham’s research relies on community involvement. In schools, that means training nurses and counselors to recognize students who would benefit from pain management strategies and to provide them with those cognitive behavioral tools. In medical settings, it means helping health care workers understand how psychological care improves physical health. Her research also shows that people want a connection with a human provider — whether in a virtual setting or in person — and that this human element helps people stick with treatment and maximizes their benefit from care.

“I think there is power in building community support to address the common problems that we face,” Cunningham says.

Cunningham herself grew up experiencing migraines in an area with limited behavioral health resources. At the time, it was not commonly understood that psychological therapies could relieve pain symptoms. This inspired Cunningham to help vulnerable populations like children and to develop tools they can access. Kara acknowledges that joining the study was an opportunity not every child can have. “I am thankful that my mom listened to me, that the doctors listened to me and that we had the time and resources to do this,” she says.

Like any parent, Sondra felt the effects of her daughter’s struggles and path toward healing as her own. Participating in the study gave her coping strategies, too, as well as reassurance that Kara’s pain was real — and that she wasn’t failing as a mother. “The study helped me help her and support her. And by helping her, it really helped us as a family.”

With federal funding like the NIH grant that supported the development and testing of the ADAPT program, MSU research will continue creating treatments that give more people access to life-changing care. With the ADAPT study Kara and others participated in now completed, Cunningham and her colleagues hope to share results soon and are also working to expand access to such care across Michigan — so far training about 100 school providers in the state. They have reported that the training improves symptoms and keeps children in school. International settings in Sweden and Spain are also adapting these tools for use in their communities, bringing hope to even more families and equipping children with the pain management tools they need to grow into thriving adults.

Find out more about taking part in Michigan State University studies as a volunteer.