Bio-psycho-social characteristics and impact of musculoskeletal pain in one hundred children and adolescents consulting general practice

Abstract

Background Eight percent of all child and adolescent general practice consultations are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain. The purpose of this study was to describe characteristics of children and adolescents consulting their general practitioner with musculoskeletal pain. Methods This is a cross-sectional study based on baseline data from the child and adolescent musculoskeletal pain cohort study (ChiBPS), carried out in 17 Danish general practice clinics. Patients aged 8–19 years who had musculoskeletal pain when consulting their general practitioner were recruited. Participants completed a questionnaire on demographics, physical activity, pain impact, psychosocial factors, and expectations of their general practitioner. Descriptive statistics were used to summarize data. Normally distributed continuous data were described using mean and standard deviation while non-normally data were described using median and interquartile range (IQR). Results We included 100 participants (54% female, median age 13 [IQR: 12–16.5 years]). Frequent pain sites limiting activity were knee (56%), back (20%), ankle (19%), and neck (13%). Most participants (63%) consulted their general practitioner due to inability to use their body as usual, due to pain. Median pain duration at consultation was 5 months [IQR: 3 weeks-1 year]. More than a third were often/sometimes nervous (34%), worried or anxious (33%), and took pain medication (33%). Pain impeded ability to participate in sport activities at school (79%) and disturbed spare time activities (88%). Pain also made it difficult to concentrate for 58%, and to fall asleep for 38%. Only 38% expected a pain free long-term future. Conclusion This study demonstrates the bio-psycho-social impact of musculoskeletal pain in care-seeking children and adolescents. Demographics, pain characteristics, psychosocial characteristics, and physical characteristics should be included in addressing children and adolescents with musculoskeletal pain. Trial registration The ChiBPS study was pre-registered before participant recruitment (ClinicalTrials.gov Identifier: NCT03678922) date: 09.20.18.

Effects of a school-based physical activity implementation program to reduce musculoskeletal pain frequency in children aged 9 to 12: a randomised clinical trial

“…[3] MSK pain in childhood can impact children's daily activities. [4,5] For example, frequent pain can lead to school absenteeism, [6] decreased social interaction and quality of life, [7,8] and activity limitations. [9] Importantly, the impact of MSK pain may track into adulthood, suggesting that mitigating pain and its impact on childhood could have lifelong consequences.…”

Exploring User Visions for Modeling mHealth Apps Toward Supporting Patient-Parent-Clinician Collaboration and Shared Decision-making When Treating Adolescent Knee Pain in General Practice: Workshop Study

“…Between the age of 12 and 15 years, musculoskeletal complaints are the fourth most common cause for consulting general practice [ 4 ]. The most common pain site is the knee, accounting for between 30% and 50% of all presentations in this age group [ 5 ]. Previously, knee pain was considered to be benign and self-limiting [ 6 ], but recent studies have demonstrated that 40% to 50% of adolescents still struggle with pain after 2 to 5 years [ 7 ], and 7 out of 10 had reduced or halted their sports participation owing to knee pain [ 8 ].…”

Prognosis and bio-psycho-social prognostic factors in children and adolescents with musculoskeletal pain consulting general practice

“…From our 3 studies we found that musculoskeletal pain is prevalent among children and adolescents 1,2,3 , a significant proportion feel nervous or anxious 2 , and more than half worry about their cause of pain 2,3 . Our understanding of adolescents' pain experience beyond worries was rather limited, however, if fear avoidance behavior persists it may facilitate transition towards chronic pain, indicating that pain cause more than just physical limitations 4 .…”

“…NP made first contact with the entire sample frame upon recruitment for the ChiBPS study more than two years prior to study 4 2,3 . NP introduced the adolescents to study 4 without requiring a definite yes/no to participation, thus avoiding either 1) a quick and easy yes from someone who had not yet actually met the interviewer or 2) a defensive no because of too much initial pressure 85 .…”

“…From October 2018 to August 2019, NP contacted and visited general practice clinics across Denmark for recruitment purposes to the ChiBPS cohort 2,3 (Appendix E, Supplementary File 1). The aim was to recruit a sample that represented the Danish child and adolescent population with MSK pain.…”