Perspectives on the clinical significance of functional pain syndromes in children

Abstract

Functional pain syndromes (FPS) characterize a subset of individuals who experience pain and related symptoms and disability without clear structural or disease etiology. In the pediatric population, FPS hold high clinical importance due to significant prevalence rates and potential to persist into adulthood. Although extensive research has been executed to disambiguate FPS, the syndromes that fall within its spectrum remain conceptually complex and sometimes ill-defined. This paper provides an overview of available research on the classification and multifaceted etiology of FPS in youth and their effects on interpersonal, psychological, and familial function. Vital aspects of a successful multidisciplinary approach to treating this population are described; however, it is evident that future research requires more longitudinal studies.

Pain Neuroscience Education: State of the Art and Application in Pediatrics

“…This is especially relevant to those suffering from chronic pain, as the pain often emerges despite seemingly normal biological functioning. The biomedical model has now largely been replaced with a biopsychosocial model, which incorporates all of the aspects in a patient’s life that converge and potentially maintain a cycle of pain [21]. This has been determined to be a more effective conceptual and theoretical stance as it is suggested that pain cognitions are not only associated pain intensity, but may also be barriers to effective treatment if left unaddressed [22].…”

Negative Emotional Reactivity and Somatic Symptoms during Adolescence Predict Adult Health and Wellbeing in Early and Middle Adulthood

“…Somatic symptoms and negative emotional reactivity have been associated with adverse psychological and social consequences in adolescence, including absence from school, reduced academic achievement, and impaired work ability (Basch et al, 2015 ; Winding & Andersen, 2019 ). These consequences provide insights into the current findings, that they also predict adult health and wellbeing in early adulthood and middle adulthood.…”

Targeting the stress response in pediatric pain: current evidence for psychosocial intervention and avenues for future investigation

“…The diagnostic conceptualization of pediatric chronic pain is often formulated using the BPS model of pain. 4 , 35 This model asserts that pain chronicity occurs because of the interaction between central sensitization or centralization of pain and HPA axis hyperactivity, in conjunction with psychological (eg, anxiety, depression, pain catastrophizing, and fear of pain) and social (eg, decreased social engagement and school attendance) factors contributing to functional disability and, in turn, pain chronicity. 34 , 35 The pain feedback loop is exacerbated by these sociobiological loads, producing a failure of homeostasis and increased allostatic load (AL), ie, wear and tear on regulatory systems, including the nervous system, in response to repeated or prolonged stress.…”