Chronic widespread pain in children and adolescents presenting in primary care: prevalence and associated risk factors

Somayajula, Glenys; Campbell, Paul; Protheroe, Joanne; Lacey, Rosie; Dunn, Kate M.

Abstract

A significant proportion of children/adolescents report Chronic Widespread Pain (CWP), but little is known about clinically relevant CWP or what factors lead to onset in this population. Objectives were to report the primary care consultation prevalence of CWP, and investigate risk factors associated with onset. A validated algorithm for identifying CWP status from primary care electronic healthcare records, was applied to a child/adolescent population (aged 8 to 18 years). The algorithm records patients who have recurrent pain consultations (axial skeleton and upper or lower limbs), or those with a non-specific generalised pain disorder (e.g. fibromyalgia). Prevalence was described, and a nested case-control study established to identify risk factors associated with CWP onset using logistic regression producing Odds Ratios (OR) and 95% Confidence Intervals (95%CI). 271 children/adolescents were identified with CWP, resulting in a five-year consultation prevalence of 3.19%. Risk factors significantly associated with CWP onset were; mental health (e.g. anxiety/neurosis consultations), neurological (e.g. headaches), genitourinary (e.g. cystitis), gastrointestinal (e.g. abdominal pain) and throat problems (e.g. sore throats). Children/adolescents
with one or two risk factors (OR 2.15, 95% CI 1.6 to 2.9) or three or more risk factors (OR 9.17, 95% CI 5.9 to 14.3) were at significantly increased odds of CWP onset compared to those with none. Findings show a significant proportion of the child/adolescent primary care population have CWP. The majority of risk factors involved pain-related conditions, suggesting potential pathways of pain development. Further work is now needed to better understand the development of CWP in children and adolescents.

Citation

Somayajula, G., GG, S., Campbell, P., P, C., Protheroe, J., J, P., …KM, D. (2021). Chronic widespread pain in children and adolescents presenting in primary care: prevalence and associated risk factors. PAIN, 163(2), E333-E341. https://doi.org/10.1097/j.pain.0000000000002354

• Journal Article Type: Article
• Acceptance Date: May 19, 2021
• Online Publication Date: Jun 4, 2021
• Publication Date: 2021-06
• Publicly Available Date: May 26, 2021
• Journal: Pain
• Print ISSN: 0304-3959
• Publisher: Lippincott, Williams & Wilkins
• Volume: 163
• Issue: 2
• Pages: E333-E341
• DOI: https://doi.org/10.1097/j.pain.0000000000002354
• Keywords: Anesthesiology and Pain Medicine, Neurology (clinical), Neurology
• Publisher URL: https://journals.lww.com/pain/Abstract/9000/Chronic_widespread_pain_in_children_and.98002.aspx
• PMID: 34108433