Pain Widespreadedness, and Not Primary Pain Location, is Associated With Comorbid Symptoms in Children With Chronic Pain.
Journal
The Clinical journal of pain
ISSN: 1536-5409
Titre abrégé: Clin J Pain
Pays: United States
ID NLM: 8507389
Informations de publication
Date de publication:
01 01 2023
01 01 2023
Historique:
received:
08
02
2022
accepted:
14
10
2022
entrez:
16
12
2022
pubmed:
17
12
2022
medline:
20
12
2022
Statut:
epublish
Résumé
Pediatric chronic pain represents heterogeneous diagnoses; often, primary pain location informs research classifications and treatment. In contrast, recent research has highlighted the role of widespread pain and this perspective has been adopted in assessments in specialty pediatric pain clinics. The lack of direct comparison between these 2 methods of categorizing pediatric chronic pain may hinder the adoption of evidence-based practices across the spectrum of care. Therefore, this study aimed to compare whether primary pain location or pain widespreadedness is more informative for pain-related symptoms in pediatric chronic pain. Youth (n=223) between the ages of 8 to 23 years (M=15.93, SD=2.11, 83% female) completed surveys upon intake at the pediatric chronic pain clinic. Free-text entries of primary pain location were coded into categories: headache, abdominal pain, and musculoskeletal pain. Additional domains assessed included widespread pain, pain interference, kinesiophobia, catastrophizing, anxiety, depression, sleep, and fatigue. Differences based on primary pain location only emerged for kinesiophobia, F(2150)=8.20, P<0.001, with the highest scores among those with musculoskeletal pain. In contrast, controlling for sex, age, and pain intensity, pain widespreadedness was associated with pain interference, pain catastrophizing, fatigue, anxiety, and depression (P<0.05). Pain widespreadedness was more consistently associated with pain-related outcomes among pediatric chronic pain patients than primary pain location, and body maps may be useful in determining a nociplastic pain mechanism to inform treatment. Improved assessment of pediatric pain mechanisms may help advance more precise treatment delivery.
Identifiants
pubmed: 36524767
doi: 10.1097/AJP.0000000000001083
pii: 00002508-202301000-00001
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-7Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Groenewald CB, Essner BS, Wright D, et al. The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States. J Pain. 2014;15:925–933.
Kashikar-Zuck S, Cunningham N, Sil S, et al. Long-term outcomes of adolescents with juvenile-onset fibromyalgia in early adulthood. Pediatrics. 2014;133:e592–e600.
U.S. Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. May, 2019. Available at: https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf . Accessed January 27, 2022.
Dunn KM, Jordan KP, Mancl L, et al. Trajectories of pain in adolescents: a prospective cohort study. Pain. 2011;152:66–73.
Huguet A, Miró J. The severity of chronic pediatric pain: an epidemiological study. J Pain. 2008;9:226–236.
King S, Chambers CT, Huguet A, et al. The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain. 2011;152:2729–2738.
Asmundson GJ, Noel M, Petter M, et al. Pediatric fear-avoidance model of chronic pain: foundation, application and future directions. Pain Res Manag. 2012;17:397–405.
McGarrigle L, Wesson C, DeAmicis L, et al. Psychological mediators in the relationship between paediatric chronic pain and adjustment: an investigation of acceptance, catastrophising and kinesiophobia. J Contextual Behav Sci. 2020;18:294–305.
Vervoort T, Goubert L, Eccleston C, et al. Catastrophic thinking about pain is independently associated with pain severity, disability, and somatic complaints in school children and children with chronic pain. J Pediatr Psychol. 2006;31:674–683.
Max MB. Is mechanism-based pain treatment attainable? Clinical trial issues. J Pain. 2000;1:2–9.
Raja SN, Carr DB, Cohen M. The revised IASP definition of pain: concepts, challenges, and compromises. Pain. 2020;161:1976–1982.
Kosek E, Cohen M, Baron R, et al. Do we need a third mechanistic descriptor for chronic pain states? Pain. 2016;157:1382–1386.
Fitzcharles MA, Cohen SP, Clauw D. Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet. 2021;397:2098–2110.
Phillips K, Clauw DJ. Central pain mechanisms in chronic pain states—maybe it is all in their head. Best Pract Res Clin Rheumatol. 2011;25:141–154.
Clauw DJ. Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s). Best Pract Res Clin Rheumatol. 2015;29:6–19.
Daffin M, Lynch-Milder MK, Gibler RC, et al. A qualitative study of risk and resilience in young adult women with a history of juvenile-onset fibromyalgia. Pediatr Rheumatol. 2021;19:128.
Law EF, Blume H, Palermo TM. Longitudinal impact of parent factors in adolescents with migraine and tension‐type headache. Headache. 2020;60:1722–1733.
Sluka KA, Clauw DJ. Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience. 2016;338:114–129.
Newton E, Schosheim A, Patel S, et al. The role of psychological factors in pediatric functional abdominal pain disorders. J Neurogastroenterol Motil. 2019;31:e13538.
Cunningham NR, Nelson S, Jagpal A, et al. Development of the Aim to Decrease Anxiety and Pain Treatment (ADAPT) for pediatric functional abdominal pain disorders. J Pediatr Gastroenterol Nutr. 2018;66:16–20.
Law EF, Beals‐Erickson SE, Noel M, et al. Pilot randomized controlled trial of internet‐delivered cognitive‐behavioral treatment for pediatric headache. Headache. 2015;55:1410–1425.
Odell S, Logan DE. Pediatric pain management: the multidisciplinary approach. J Pain Res. 2013;6:785–790.
Hechler T, Kanstrup M, Holley AL, et al. Systematic review on intensive interdisciplinary pain treatment of children with chronic pain. Pediatrics. 2015;136:115–127.
Liossi C, Johnstone L, Lilley S, et al. Effectiveness of interdisciplinary interventions in paediatric chronic pain management: a systematic review and subset meta-analysis. Brit J Anaesth. 2019;123:e359–e371.
Miró J, McGrath PJ, Finley GA, et al. Pediatric chronic pain programs: current and ideal practice. Pain Reports. 2017;2:e613.
Fisher E, Villanueva G, Henschke N, et al. Efficacy and safety of pharmacological, physical, and psychological interventions for the management of chronic pain in children: a WHO systematic review and meta-analysis. Pain. 2022;163:e1–e19.
Harrison LE, Pate JW, Richardson PA, et al. Best-evidence for the rehabilitation of chronic pain part 1: pediatric pain. J Clin Med. 2019;8:1267.
Hassett AL, Hilliard PE, Goesling J, et al. Reports of chronic pain in childhood and adolescence among patients at a tertiary care pain clinic. J Pain. 2013;14:1390–1397.
Butler S, Landmark T, Glette M, et al. Chronic widespread pain—the need for a standard definition. Pain. 2016;157:541–543.
Wolfe F, Butler SH, Fitzcharles M, et al. Revised chronic widespread pain criteria: development from and integration with fibromyalgia criteria. Scand J Pain. 2020;20:77–86.
Amris K, Wæhrens EE, Bliddal H, et al. How widespread should pain be to be defined as widespread? Pain. 2016;157:1831–1832.
Logan DE, Donado C, Kaczynski K, et al. From one pain to many: the emergence of overlapping pains in children and adolescents. Clin J Pain. 2021;37:404–412.
Williams DA. Phenotypic features of central sensitization. J Appl Biobehav Res. 2018;23:e.12135.
Rabbitts JA, Holley AL, Groenewald CB, et al. Association between widespread pain scores and functional impairment and health-related quality of life in clinical samples of children. J Pain. 2016;17:678–684.
Williams SE, Homan KJ, Crowley SL, et al. The impact of spatial distribution of pain on long-term trajectories for chronic pain outcomes after intensive interdisciplinary pain treatment. Clin J Pain. 2020;36:181–188.
Brummett CM, Bakshi RR, Goesling J. Preliminary validation of the Michigan Body Map (MBM). Pain. 2016;157:1205–1212.
Foxen‐Craft E, Scott EL, Kullgren KA, et al. Pain location and widespread pain in youth with orthopaedic conditions: exploration of the reliability and validity of a body map. Eur J Pain. 2019;23:57–65.
Keller S, Bann CM, Dodd SL, et al. Validity of the Brief Pain Inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004;20:309–318.
Théroux J, Le May S, Hebert JJ, et al. Back pain prevalence is associated with curve-type and severity in adolescents with idiopathic scoliosis. Spine. 2017;42:E914–E919.
Engel JM, Kartin D, Carter GT, et al. Pain in youths with neuromuscular disease. Am J Hosp Palliat Med. 2009;26:405–412.
Yu L, Buysse DJ, Germain A, et al. Development of short forms from the PROMIS sleep disturbance and sleep-related impairment item banks. Behav Sleep Med. 2012;10:6–24.
Hanish AE, Lin-Dyken DC, Han JC. PROMIS sleep disturbance and sleep-related impairment in adolescents: examining psychometrics using self-report and actigraphy. Nurs Res. 2017;66:246–251.
van Kooten JA, van Litsenburg RR, Yoder WR, et al. Validation of the PROMIS sleep disturbance and sleep-related impairment item banks in Dutch adolescents. Qual Life Res. 2018;27:1911–1920.
Cella D, Lai JS, Jensen SE, et al. PROMIS fatigue item bank had clinical validity across diverse chronic conditions. J Clin Epidemiol. 2016;73:128–134.
Robinson ME, Riley JLI, Myers CD, et al. The Coping Strategies Questionnaire: a large sample, item level factor analysis. Clin J Pain. 1997;13:43–49.
Miller RP, Kori SH, Todd DD. The Tampa scale: a measure of kinesiophobia. Clin J Pain. 1991;7:51.
Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiat Scand. 1983;67:361–370.
White D, Leach C, Sims R, et al. Validation of the Hospital Anxiety and Depression Scale for use with adolescents. Brit J Psychiat. 1999;175:452–454.
Dworkin RH, Turk DC, Farrar JT, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. 2005;113:9–19.
Kashikar-Zuck S, Briggs MS, Bout-Tabaku S, et al. Randomized clinical trial of Fibromyalgia Integrative Training (FIT teens) for adolescents with juvenile fibromyalgia–study design and protocol. Contemp Clin Trials. 2021;103:106321.
Sherry DD, Brake L, Tress JL, et al. The treatment of juvenile fibromyalgia with an intensive physical and psychosocial program. J Pediatrics. 2015;167:731–737.
von Baeyer CL, Lin V, Seidman LC, et al. Pain charts (body maps or manikins) in assessment of the location of pediatric pain. Pain Manag. 2011;1:61–68.
Louw A, Nijs J, Puentedura EJ. A clinical perspective on a pain neuroscience education approach to manual therapy. J Manual Manipulat Ther. 2017;25:160–168.
Louw A, Diener I, Butler DS, et al. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehab. 2011;92:2041–2056.
Clauw DJ, Häuser W, Cohen SP, et al. Considering the potential for an increase in chronic pain after the COVID-19 pandemic. Pain. 2020;161:1694–1697.
Shen J, Barbera J, Shapiro CM. Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev. 2006;10:63–76.
Valrie CR, Bromberg MH, Palermo T, et al. A systematic review of sleep in pediatric pain populations. J Dev Behav Ped. 2013;34:120–128.
Law EF, Wan Tham S, Aaron RV, et al. Hybrid cognitive‐behavioral therapy intervention for adolescents with co‐occurring migraine and insomnia: a single‐arm pilot trial. Headache. 2018;58:1060–1073.
Maixner W, Fillingim RB, Williams DA, et al. Overlapping chronic pain conditions: implications for diagnosis and classification. J Pain. 2016;17:T93–T107.