Persistent or recurring chronic pain in children may result in missing school and withdrawing from social activities. They are also at risk of developing personalized symptoms like anxiety. A group of researchers has established that more children currently suffer from chronic pain and that chronic pain is more prevalent in girls than boys. The findings are the results of the first comprehensive review of chronic pain in children and adolescents in two decades.

Study leader Sara King, PhD, currently Assistant Professor at Mount Saint Vincent University in Halifax, Nova Scotia explained:

"We found that persistent and recurrent chronic pain is overwhelmingly prevalent in children and adolescents, with girls generally experiencing more pain than boys and prevalence rates increasing with age. Findings such as these argue that researchers and clinicians should be aware of the problem and the long-term consequences of chronic pain in children."

To assess the progress made since the first comprehensive review of pain in children and adolescents was published by Goodman and McGrath in PAIN® in 1991, researchers from Dalhousie University and the IWK Health Centre in Halifax, systematically assessed epidemiological studies of pain and classified a set of criteria to assess the quality of the studies that were included in the review. They examined 32 studies, which they categorized according to types of pain, such as headache, back pain, abdominal pain, combined pain, musculoskeletal pain, and general pain.

Although the researchers observed that most types of pain were more prevalent in girls than in boys, the factors for this gender difference are not entirely clear. They noted that pain prevalence rates were likely to increase with age. The impact of pain prevalence for psychosocial variables included low socioeconomic status, low self-esteem, anxiety and depression.

The most commonly studied type of pain in youths was headache, with an estimated rate of 23%, whilst other types of pain, such as back pain, abdominal pain, musculoskeletal pain, and pain combinations, were less often studied. The prevalence rates for other types of pain proved variable due to differences in reporting, yet overall results suggested these types of pain to be highly prevalent in children and youths, with an average prevalence rate ranging from 11% to 38%.

Dr. King commented:

"These rates are of great concern, but what is even more concerning is that research suggests that the prevalence rates of childhood pain have increased over the last several decades."

According to the researchers, many studies did not meet quality criteria, with a great variation in prevalence rates across studies, because of the specific moments the pain was reported. To allow researchers to make direct comparisons in future studies, the authors recommend that new epidemiological studies in this field need to be conducted with clearer operational definitions of pain and better measures of pain intensity, frequency, and duration.

Researchers discovered that several demographic and psychosocial factors were linked to high prevalence rates of specific pain types.

Dr. King declared in a concluding statement:

"By shifting focus to factors associated with chronic and recurrent pain, it may be possible to identify the most salient risk factors, leading to early and intensive interventions for the most at-risk groups."

Written by Petra Rattue