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Background and Aims Obtaining a comprehensive history from a patient is essential to making an accurate pain assessment, diagnosis and management. In the paediatric population, collaborative history from the parents often provides valuable insight into the pain experienced by the patient. However, this may also be misleading at times.

Methods We present the case of a 10-year-old school-going girl who was admitted for a complaint of headache following an accidental head injury. A diagnosis of severe post-concussion headache was made in view of normal findings on physical examination and investigations but a pain history reporting significant pain according to the patient’s mother. The patient’s analgesic requirement escalated quickly despite an observed improvement in function. Within a few days, she became increasingly drowsy after being on high dose gabapentin and amitriptyline. Subsequently, through tactful segregation of the patient from her mother, we were able to obtain a more reliable history from the patient herself.

Results The child had difficulty conveying her symptoms due to the overbearing presence of her mother, no doubt driven by concern for her child. Consequently, the severity of the patient’s pain symptoms were consistently exaggerated by her mother. In fact, effective pain control was achievable with a simpler analgesic regime. After readjusting her medications, her pain and drowsiness improved.

Conclusions Overreliance on parental history can complicate pain assessment and management in children. Pain history should ideally be sought from the patients themselves whenever possible, even in the paediatric population.