Widespread pain and neck pain in schoolchildren. A prospective one‐year follow‐up study

Abstract

The aims of this study were to prospectively follow up population‐based cohorts of children with widespread pain, children with neck pain and pain‐free children, in order to evaluate 1‐y changes in pain symptoms and to evaluate predictors for persistent widespread pain and for the change of neck pain to widespread pain. A structured pain questionnaire, the Children's Depression Inventory, and a sleep questionnaire were completed by the pre‐adolescent cohorts, and clinical evaluation with tender point palpation and pain threshold measurements was carried out in both years. The Child Behavior Checklist, the Teacher's Report Form and a sociodemographic questionnaire were completed at baseline. More children in the 2 pain cohorts reported pain at follow‐up than did controls (p<0.0001). Children with persistent widespread pain had lower pain thresholds compared with those whose pain classification changed. In the neck pain group, 19 (20.4%) reported widespread pain at follow‐up. Although depressive symptoms and sleep problems were associated with the change of neck pain to widespread pain, neither they nor other measured factors showed independent explanatory power in multiple logistic regression analysis. In conclusion, fluctuation of pain symptoms occurred mainly among pain cohorts. Depressive and sleep problems may have an effect on the spreading of regional neck pain to widespread pain. Pain threshold measurement and evaluation of depressive and sleep problems may be useful tools for secondary prevention of musculoskeletal pain in pre‐adolescents.

Course and Prognostic Factors for Neck Pain in the General Population

“…23,24 Similarly, 48% of the general practice patients who experienced initial neck pain for longer than 1 day during the previous month reported having neck pain of at least the same frequency 1 year later. 20 Reflecting somewhat more stringent criteria to define cases (the Chronic Pain Questionnaire), 25 the Canadian study of adults in the general population reports that only 36.6% (of those with prevalent pain at baseline) experienced resolution (no neck pain) within the following year, with 37.3% reporting no change (over follow-up) in neck pain intensity or disability (defined in this context as days off work due to pain and/or limitations in activities of daily living).…”

“…We deemed 6 studies (involving 5 separate cohorts of persons with neck pain) on the course of neck pain in the general population and in primary health care settings to be scientifically admissible ( 23,24 Most of the evidence indicates that between half and three quarters of people who experience neck pain at some initial point will report neck pain 1 to 5 years later. Specific findings from the studies reporting on the course of neck pain in the general population and in primary health care settings are as follows:…”

Pain Beliefs Predict Pain Intensity and Pain Status in Children: Usefulness of the Pediatric Version of the Survey of Pain Attitudes

“…Thus, both timeframe and frequency of pain were used to define chronic pain (see Mikkelson et al for a similar procedure) [17].…”

The Somatic Complaint List: Validation of a self-report questionnaire assessing somatic complaints in children

“…Therefore, the CSI-C might be more suitable when parents are the informants than for children's self-reports. To date, it is also difficult to find a short questionnaire that is suitable for children, and researchers often develop their own measurement [3,5,6]. A validation of one of these questionnaires seems necessary.…”