Applications of laboratory pain methodologies in research with children and adolescents: Emerging research trends

Wilson, Anna; Holley, Amy Lewandowski; Palermo, Tonya M.

doi:10.1016/j.pain.2013.04.014

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…Expanding laboratory assessment of pain responsiveness to other modalities and approaches is also needed [49]. This could include CPM assessment using different locations on the body, pressure pain assessed via algometer, or tests of temporal summation.…”

Section: Discussionmentioning

confidence: 99%

Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study

Holley

Wilson

Palermo

2016

Pain

Self Cite

109

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Strategies directed at the prevention of disabling pain have been suggested as a public health priority, making early identification of youth at risk for poor outcomes critical. At present limited information is available to predict which youth presenting with acute pain are at risk for persistence. The aims of this prospective longitudinal study were to identify biopsychosocial factors in the acute period that predict the transition to persistent pain in youth with new-onset musculoskeletal (MSK) pain complaints. Participants were 88 children and adolescents (age 10–17 years) presenting to the emergency department (n=47) or orthopedic clinic (n=41) for evaluation of a new MSK pain complaint (< 1 month duration). Youth presented for two study visits (T1 = <1 month post pain onset; T2 = 4 month follow-up) during which they completed questionnaires (assessing pain characteristics, psychological factors, sleep quality) and participated in a lab task assessing conditioned pain modulation (CPM). Regression analyses tested T1 predictors of longitudinal pain outcomes (pain persistence, pain-related disability, quality of life). Results revealed approximately 35% of youth had persistent pain at 4-month follow-up, with persistent pain predicted by poorer CPM and female sex. Higher depressive symptoms at T1 were associated with higher pain-related disability and poorer quality of life at T2. Findings highlight the roles of depressive symptoms and pain modulation in longitudinally predicting pain persistence in treatment-seeking youth with acute MSK pain, and suggest potential mechanisms in the transition from acute to chronic MSK pain in children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study

Holley

Wilson

Palermo

2016

Pain

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109

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“…Greater sensitivity (to heat and cold) in the chronic pain group supports some previous research however findings regarding differences in pain sensitivity among youth with chronic pain and healthy comparison samples are largely equivocal. Prior studies have found differences depending on the pain sensitivity task (e.g., thermal versus pressure), body location chosen as the testing site, chronic pain location (e.g., abdominal pain) or presence of a chronic health condition (e.g., arthritis) [46]. Additional research should examine pain sensitivity in youth with new onset musculoskeletal pain using additional modalities such as pressure pain assessed via algometer, or pain sensitivity testing at multiple locations on the body to determine if findings differ by experimental methodology.…”

Section: Discussionmentioning

confidence: 99%

Clinical Phenotyping of Youth With New-Onset Musculoskeletal Pain

Holley

Wilson²,

Cho³

et al. 2017

The Clinical Journal of Pain

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Objectives The course of pediatric musculoskeletal pain from acute to chronic has not been well described and there is limited understanding of how to identify individuals with new onset pain who may be predisposed to developing persisting symptoms. Thus, the purpose of this study was to describe the clinical phonotype of treatment-seeking youth with new onset musculoskeletal pain compared to youth with and without chronic pain. Further, we tested predictors of pain-related disability and pain sensitivity in the new onset pain sample. Methods Participants were 191 youth ages 10–17 years representing three cohorts (new onset musculoskeletal pain, chronic musculoskeletal pain, and a comparison group without chronic pain). Youth completed questionnaire measures of pain characteristics, psychological functioning, sleep and pain-related disability. They also attended a laboratory visit to complete an experimental pain assessment using heat and cold stimuli to assess pain sensitivity and conditioned pain modulation. Results Findings revealed youth with new onset musculoskeletal pain had a distinct clinical phenotype where symptoms of pain and disability were in the mid-range between those of youth with diagnosed chronic musculoskeletal pain and youth in the community without chronic pain. Linear regressions within the new onset pain sample demonstrated poorer sleep quality and higher pain fear predicted greater pain-related disability, and pain catastrophizing predicted cold pressor sensitivity. Discussion Clinical phenotyping of youth with new onset musculoskeletal pain highlights factors relevant to the pain experience. Future research can examine the roles of these variables in predicting longitudinal risk for chronic pain and disability.

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“…Familiarity with and use of multiple experimental pain modalities within single studies will increase given their particular benefit for understanding pain modulation and central processing [39,53,84]. Use of experimental methods to examine early pain experiences and identify biopsychosocial risk factors in childhood will lead our understanding of how and for whom chronic pain develops later in life [98]. …”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

A Practical Guide and Perspectives on the Use of Experimental Pain Modalities with Children and Adolescents

et al. 2014

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Use of experimental pain is vital for addressing research questions that would otherwise be impossible to examine in the real world. Experimental induction of pain in children is highly scrutinized given the potential for harm and lack of direct benefit to a vulnerable population. However, its use has critically advanced our understanding of the mechanisms, assessment and treatment of pain in both healthy and chronically ill children. This article introduces various experimental pain modalities, including the cold pressor task, the water load symptom provocation test, thermal pain, pressure pain and conditioned pain modulation, and discusses their application for use with children and adolescents. It addresses practical implementation and ethical issues, as well as the advantages and disadvantages offered by each task. The incredible potential for future research is discussed given the array of experimental pain modalities now available to pediatric researchers

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Applications of laboratory pain methodologies in research with children and adolescents: Emerging research trends

Cited by 9 publications

References 38 publications

Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study

Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study

Clinical Phenotyping of Youth With New-Onset Musculoskeletal Pain

A Practical Guide and Perspectives on the Use of Experimental Pain Modalities with Children and Adolescents

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