Prevalence Of Pain In Children Research Articles

The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis.

Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023. Studies reporting population-based estimates of chronic nondisease related pain prevalence in children or adolescents (age ≤ 19 years) were included. Two independent reviewers screened articles based on a priori protocol. One hundred nineteen studies with a total of 1,043,878 children (52.0% female, mean age 13.4 years [SD 2.4]) were included. Seventy different countries were represented, with the highest number of data points of prevalence estimates coming from Finland and Germany (n = 19 each, 4.3%). The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%). Overall, and for all types of pain except for back pain and musculoskeletal pain, there were significant differences in the prevalence between boys and girls, with girls having a higher prevalence of pain. There was high heterogeneity (I 2 99.9%). Overall risk of bias was low to moderate. In summary, approximately 1 in 5 children and adolescents experience chronic pain and prevalence varies by pain type; for most types, there is higher pain prevalence among girls than among boys. Findings echo and expand upon the systematic review conducted in 2011.

Prevalence of chronic pain in children and adolescents with psychiatric conditions.

The prevalence of pain in children and adolescents with psychiatric conditions is rarely investigated. The aims of the current study were to (a) describe the prevalence of headaches and abdominal pain in children and adolescents with psychiatric conditions, (b) compare the prevalence of pain in children and adolescents with psychiatric conditions with that in the general population, and (c) investigate the associations between pain experience and different types of psychiatric diagnoses. Families with a child aged 6-15 years who had been referred to a child and adolescent psychiatry (CAP) clinic completed the Chronic Pain in Psychiatric Conditions questionnaire. Information about the child/adolescent's psychiatric diagnosis(es) was extracted from the CAP clinic's medical records. The children and adolescents included in the study were divided into diagnostic groups and compared. Their data were also compared with data of control subjects collected during a previous study of the general population. Abdominal pain was more common among girls with a psychiatric diagnosis (85%) than in the matched control population (62%, p=0.031). Children and adolescents with neurodevelopmental diagnoses had a higher prevalence of abdominal pain than children and adolescents with other psychiatric diagnoses. Pain conditions in children and adolescents with a psychiatric diagnosis are common and must be addressed.

Epidemiology of chronic pain in children and adolescents: a protocol for a systematic review update

IntroductionChronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem and can profoundly impact children’s physical, psychological and social functioning....

Psychometric Properties of the Abdominal Pain Index (API) in the Iranian Adolescent Population.

Considering the high prevalence of abdominal pain in children and adolescents in Iran, it is essential to use appropriate screening tools. One of the most comprehensive, yet concise, tools for this purpose is the Abdominal Pain Index (API). This study aimed to investigate the psychometric properties of the Persian version of the self-report API in adolescents. In this descriptive study, A total of 162 Iranian adolescents in the age range of 12 to 18 years were considered as the sample group, which included two groups of school students (n = 125) and adolescent patients with abdominal pain (n = 37). Clinical sample was selected by the available sampling method, and nonclinical sample was selected by the cluster sampling method. Adolescents in the sample group were selected from both clinical and nonclinical groups in order to evaluate differential validity. Instruments, including API, somatic symptoms subscale of the General Health Questionnaire (GHQ), and McGill Pain Questionnaire (MPQ), were also completed for the participants. Also, to evaluate the construct validity of API, exploratory and confirmatory factor analysis methods were applied. The exploratory factor analysis identified one general factor, and the confirmatory factor analysis results show the model's satisfactory fitting. Also, the researchers' hypothesis, i.e., API is a single-factor model (with five items), was approved. The reliability coefficient of the questionnaire was satisfactory for the total scale (α < 0.7). This study showed that API could be used with considerable confidence for Iranian children and adolescents with chronic pain.

Pain in children with dyskinetic and mixed dyskinetic/spastic cerebral palsy.

To evaluate pain prevalence and characteristics in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) cerebral palsy (CP) motor types. Seventy-five participants with a diagnosis of CP and confirmed dyskinetic or mixed (dyskinetic/spastic) motor type took part in a multisite cross-sectional study. The primary outcome was carer-reported pain prevalence (preceding 2wks) measured using the Health Utilities Index-3. Secondary outcomes were chronicity, intensity, body locations, quality of life, and activity impact. Mean participant age was 10years 11months (SD 4y 2mo, range 5-18y). There were 44 males and 31 females and 37 (49%) had predominant dyskinetic CP. Pain was prevalent in 85% and it was chronic in 77% of participants. Fifty-two per cent experienced moderate-to-high carer-reported pain intensity, which was significantly associated with predominant dyskinetic motor types (p=0.008). Pain occurred at multiple body locations (5 out of 21), with significantly increased numbers of locations at higher Gross Motor Function Classification System levels (p=0.02). Face, jaw, and temple pain was significantly associated with predominant dyskinetic motor types (p=0.005). Poorer carer proxy-reported quality of life was detected in those with chronic pain compared to those without (p=0.03); however, chronic pain did not affect quality of life for self-reporting participants. Pain was highly prevalent in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types, highlighting a population in need of lifespan pain management. Chronic pain prevalence in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types is high. Pain occurs across multiple body locations in predominant dyskinetic and mixed (dyskinetic/spastic) motor types. Less recognized locations of pain include the face, jaw, and temple for predominant dyskinetic motor types.

Prevalence and characteristics of pain in children and young adults with cerebral palsy: a systematic review.

The primary aim of this review is to evaluate the evidence for pain prevalence in children and young adults with cerebral palsy. Secondary aims are to identify pain characteristics and types of pain measurement used in this population. Ovid MEDLINE, Embase, CINAHL Plus, and PubMed were searched in October 2016 and updated in November 2017. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pain outcomes were categorized within a biopsychosocial pain framework, with pain prevalence extracted for all recall periods and measurement types. One hundred and six publications from 57 studies met inclusion criteria. Pain prevalence varied widely from 14 per cent to 76 per cent and was higher in females, older age groups, and those classified within Gross Motor Function Classification System level V. Pain was most frequent in the lower limbs, back, and abdomen and associated with reduced quality of life or health status. The influence of pain on psychological functioning, interference, and participation was inconclusive. Variation exists in reported pain prevalence because of sampling bias, inconsistent measurement, varying recall periods, and use of different participant age ranges. Pain prevalence varies from 14 per cent to 76 per cent in children and young adults with cerebral palsy. Pain is more prevalent in females, older age groups, and children in Gross Motor Function Classification System level V.

Understanding the use of over-the-counter pain treatments in adolescents with chronic pain

ABSTRACTBackground: The prevalence of chronic pain in children and adolescents is well established. What is not well understood is how over-the-counter (OTC) oral and topical pain treatments are being used by adolescents with chronic pain, their decision making around use of these products, and how they communicate with their health care providers about their use.Aims: The aim of this study was to explore the use, decision-making process, and communication about the use of OTC pain medications with health care professionals among adolescents living with chronic pain and their primary caregiver.Methods: A qualitative descriptive design with semistructured, audiotaped individual interviews was undertaken with adolescents with chronic pain (n = 15, aged 12–18 years, mean age = 16, SD = 1.79) and their caregivers (n = 16). A convenience sample of patient–caregiver dyads was recruited from a tertiary care pediatric chronic pain clinic in Ontario.Results: Interview questions focused on four topics: (1) experience with chronic pain and medication; (2) perceptions of medications and concerns with long-term consumption; (3) decision making for use of OTC medications guided mainly by a trusted source or health care professional; and (4) topical OTC medications perceived as harmless. Content analysis within these four topics uncovered two to four subthemes, which are described in detail.Conclusions: An improved understanding of the prevalence of use, decision-making process around use, and how patients and their families communicate about the use of OTC pain medications with health care providers can help clinicians better personalize treatments and help adolescents with chronic pain to make sound self-care decisions.

Pain prevalence in hospitalized children: a prospective cross-sectional survey in four Danish university hospitals.

Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. Two hundred and thirteen children (37%) responded that they had experienced pain in the previous 24 hours. One hundred and thirty four (24%) indicated moderate to severe pain and 43% would have preferred an intervention to alleviate the pain. In children hospitalized for more than 24 hours, the prevalence of moderate/severe pain was significantly higher compared to children admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority of children in moderate to severe pain did not have a documented pain assessment, and evidence-based pharmacological and/or integrative ('non-pharmacological') measures were not systematically administered to prevent or treat pain. Thus, practice changes are needed.

Postoperative paediatric pain prevalence: A retrospective analysis in a university teaching hospital

BackgroundOverall pain prevalence in paediatric patients is well documented, but relatively little attention has been paid to pain prevalence and intensity on specific postoperative days within the first week following an operation. ObjectivesTo evaluate reported pain prevalence on the day of surgery and each day during the following week and to analyse pain trajectories. DesignRetrospective study. SettingSingle centre university hospital. Participants815 postoperative children and adolescents (age≤18 years) were included (female: 36%, age 9.8±5.8). Children with ear, nose, throat (e.g. tonsillectomy), eye (e.g. strabismus repair) or dental surgery (e.g. dental extraction) were treated at other departments and therefore were not included in this study. MethodsRetrospective analysis of the overall and clinically relevant (pain score ≥4/10) postoperative pain prevalence in children and adolescents during the first week after surgery. Possible influencing factors (age, sex, body mass index, type of anaesthesia, type of surgery and duration of surgery) on pain trajectories are analysed using mixed model techniques. ResultsOverall, 36% of 815 analysed children and adolescents suffered from pain ≥4 during their entire hospital stay. Compared to the day of surgery, the number of patients with pain ≥4 was slightly higher on day 1 after surgery (21% vs. 25%, respectively). In self-reported pain intensity rating (done for patients age≥4 years) the type of surgery (p<.001) was the only significant variable influencing pain intensity. In observational pain assessment (age<4 years) pain scores increased with patient's age (p=.004). In this patient group, pain intensity ratings did not differ between types of surgery (p=.278). ConclusionType of surgery is an important predictor for self-reported pain intensity ratings in children but not for observational pain assessment in younger children. In younger children observational pain assessment ratings increase with age.

Musculoskeletal effects of heavy backpacks in school children of 11-14 years of age

Background/Objectives: High and increasing prevalence of back pain in children and adolescent is matter of concern. Prevalence varies regionally as it depends on many variables. Heavy backpack is one of the important underlying causes. Adolescent spine is in the critical stage of development in the age group of 11-14 years. This study was carried out to decide regional cutoffs of heavy relative weights of backpacks in male and female children. Methods: In a community based co-relational study 249 male and 251female children in the age group of 11-14 yrs using backpack from 6 schools of Kolhapur city, Maharashtra, India were studied. Musculoskeletal effects were noted as per Nordic Musculoskeletal Questionnaire. Data was recorded in MS Excel worksheet and statistically analyzed using computer assisted statistical software SPSS Package Version-20. Results: Musculoskeletal problems due to heavy backpacks were found in 60.6% of children; 55.02% males and 66.53% females. Prevalence increased with increasing relative weight of backpack both in male and female children. With relative weight of backpack ≤ 11%, most children were asymptomatic. Relative weight of 12% to 13% showed statistically insignificant prevalence of musculoskeletal symptoms. With a relative weight of backpack ≥14% in males and ≥ 15% in females, prevalence of musculoskeletal symptoms steeply increased. Conclusions: Relative weight of backpack ≤ 11% is safe to carry. As relative weight of backpack increases to ≥ 15%, majority of adolescent children in the age group of 11-14 years in this region are at risk of developing musculoskeletal adverse effects.

Répondre à la douleur des enfants atteints de paralysie cérébrale

With SPARCLE studies, the prevalence of pain in children with cerebral palsy is now better known: 60% of children aged 8 to 12-years-old and amounts to 69% in adolescents 13 to 17-years-old. The pain relief was also identified as a priority issue in a prospective study of la Fondation Motrice published in 2009. Yet iatrogenic pain is under-treated in this population although many assessment tools are validated. The use of assessment tools requires good knowledge of their psychometric properties and limitations. But pain assessment is not limited to the application of a scale. Current knowledge regarding the pain expression and ability to cope in this population are essential. International guidelines stress the importance of a multidisciplinary approach from assessment to management, in way to increase the synergistic effects of several therapeutic options (pharmacological and non-pharmacological). Finally, it also seems worthwhile to question our representations of pain reported by those with atypical development.

Weight of school material and back pain in students leaving their books at school

BACKGROUND AND OBJECTIVES: The prevalence of back pain in children and adolescents has been reason for school health concern. Among different causes, school material weight is highlighted since studies have shown that it exceeds recommended values. So, strategies to decrease material weight have been adopted, such as the availability of cabinets or shelves to leave the books at school. However, it is not well explained whether such strategies would solve the problem. This study aimed at observing the association between school material weight and back pain in students who leave their material at school. METHODS: Sample was made up of 48 students of the 5th year of Basic Education of a municipal school of Petrolina-PE. Students and their materials were weighed. The back pain and body posture evaluation instrument was used to evaluate back pain. RESULTS: Mean school material weight was 10.8±3.9% of body weight, without difference between genders. From 48 students, 20 have reported back pain and there has been no association between back pain and gender or school material weight. CONCLUSION: Among students, 41.67% have reported back pain, while 52.09% carried weight above 10% of body weight, but there has been no association between school material weight and back pain.

O-144 Pain Prevalence And Practices In Surgical And Non-surgical Paediatric And Neonatal Patients

Background and aims Despite international standards for the assessment and management of paediatric pain, pain remains poorly treated. This study aimed to determine pain prevalence and pain management practices in surgical and non-surgical paediatric and neonatal patients. Methods Following ethics approval, pain prevalence data were collected retrospectively in six paediatric and one neonatal unit of a tertiary referral hospital in Western Switzerland in the previous 24 h (J-1). Patients had to be hospitalised for at least 24 h to be included. Medical and nursing notes were reviewed to describe pain management practices. A Pain Management Index (PMI) was calculated. A PMI of 0 reflects optimal pain management, ≥ 0 can reveal overtreatment, and Results 73 patients had documented pain scores, 43(58.9%) were aged ≥3 years and 28(38.4%) had surgery. Pain prevalence at J-1 wasn’t significantly higher (28.6%) in surgical patients, compared to non-surgical (26.7%) (p = 0.859). There was no significant differences between pain prevalence in children >3 years of age (32.6%) and younger patients (20.0%), (p = 0.292). Better treatment for pain (PMI=0) was given to non-surgical patients (65, 8%), compared to surgical (33.3%, p = 0.019) and patients aged three and less (71.4%) compared to older patients (38.7%, p = 0.028). Conclusions Although no significant, pain prevalence remains high in surgical patients and children > 3 years of age, which is reflected by less adequate pain treatment, when compared to non-surgical and younger patients. This may be explained by the difficulties in assessing and managing postoperative pain in early verbal children. Acknowledgements/disclosures We sincerely thank the Nursing Director of the Paediatric Department, Mr Rui Terra, for his precious support throughout the project and Ms Diane Morin for her assistance in data entry. No disclosure to declare.

Prevalence of Pain in Children and Youth With Cerebral Palsy in an Outpatient Setting: Agreement Between Patient/Caregiver and Physician Report of Pain

Prevalence of Pain in Children and Youth With Cerebral Palsy in an Outpatient Setting: Agreement Between Patient/Caregiver and Physician Report of Pain

Out-of-hospital emergency medicine in pediatric patients: prevalence and management of pain

Introduction Much less is known about pain prevalence in pediatric patients in an out-of-hospital than emergency department setting. The purpose of this study was to determine pain prevalence in children in a prehospital emergency setting and to identify the factors associated with pain relief. Materials and Methods This prospective cohort study in consecutive patients 15 years or younger was conducted by 5 mobile intensive care units working 24/7 (January-December 2005). The presence of pain, its intensity, and alleviation by the administration of analgesics were recorded. Results A total of 258 of 433 pediatric patients were included, of whom 96 were suffering from acute pain (37%; 95% confidence interval [CI], 31-43) that was intense to severe in 67% of cases. Trauma was the only factor significantly associated with acute pain (odds ratio, 818; 95% CI, 153-4376). Overall, 92% of the children in pain received at least one analgesic drug; 41% received a combination of drugs. Opioid administration was significantly associated with intense to severe pain (odds ratio, 7; 95% CI, 2-25). On arrival at hospital, 67% of the children were still in pain; but 84% had experienced some pain relief regardless of their sex, age, or disorder. Conclusion In a prehospital emergency setting, more than a third of children experience acute pain with a high prevalence of intense to severe pain. Scoring pain in children, and especially in the newborn, is beleaguered by a lack of suitable scales. Despite this, it was possible to treat 90% of children in pain and provide relief in 80% of cases.

Schmerzen und Schmerzmanagement bei Kindern in Greifswald und Ostvorpommern: Vergleich mit den Ergebnissen des Kinder- und Jugendgesundheitssurveys (KiGGS)

Pain in children and adolescents in Germany is a common health problem which has a high socioeconomic impact. There have been no studies allowing a reliable estimation of the prevalence of pain in children in the 5 (th) grade (age range 9-13 years) in schools in the region of the city of Greifswald and the administrative district East Pomerania. This population-based cross-sectional study examined the prevalence of pain in children, the treatment of pain and compared these data with the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Data were collected within the extended dental school examination in autumn 2007 including a self-completion questionnaire for the students. Also the parents answered a self-completion questionnaire containing questions on their children's socio-economic status. The pain and sociodemographic questions are compatible with those used in the "German Health Survey for Children and Adolescents" (KiGGS). Students from 19 schools completed a questionnaire on general pain (n=852, proportion of response: 93.2%, mean age: 10 years). Comparing to the KiGGS the overall 3-month prevalence is much higher (95.5%). For boys and girls headache is the pain associated with the most burden ("Hauptschmerz"). 1/4 of the girls (27.9%) and 1/5 (22.4%) of the boys reported their pain with the most burden during the last 3 months with a frequency of at least one time per week. Students with low socio-economic status took medication against pain ("Hauptschmerz") less frequently than students with high socio-economic status. Because of their pain ("Hauptschmerz") students with low socio-economic status visited a doctor less often than students with a mean or high socio-economic status. Compared to other epidemiological studies, pain is also a common health problem for children in the city of Greifswald and the administrative district East Pomerania. The data base enables comprehensive conclusions on the health-related state of students in Greifswald/East Pomerania. Further studies should examine additional factors on medication and the degree of doctor?s visits, e. g., parental attitudes towards medication and parental motivation towards the degree of visiting a doctor.

SITTING HABITS IN ELEMENTARY SCHOOLCHILDREN

The results from non-clinical studies on back pain prevalence in children and adolescents reporting a high occurrence of back pain in the growing child, favor early back pain prevention. Since sitting is found to be strongly associated with back pain in children and adolescents, the possible effects of preventive actions including this factor need to be studied. According to a prior study, it seems reasonable to focus not only on adjusted or “proper” sitting, but also on the duration and the frequency of sitting in the classroom. PURPOSE The aim of the present study is to evaluate the impact of a pilot project “Moving school” on the posture, duration and frequency of sitting in the classroom in 8 year old elementary schoolchildren. “Moving school” encourages movement into the lessons through work organisation, and through circumstantial and behavioural influence. METHODS 22 Children, since 1.5 years involved in the project “Moving School”, were compared to 25 children in a traditional school, making use of the Portable Ergonomic Observation (PEO) method and Computer Science and Applications accelerometry. RESULTS It was observed that children from a traditional school spend an average of 97% of the lesson time sitting statically, from which one third with the trunk bend over 45°. In the “Moving school” this posture was replaced by dynamic sitting (53%), standing (31%) and walking around (10%), while trunk flexion over 45° was nearly not observed. Children from the “Moving school” also showed significantly less neck and trunk rotation. Additionally, accelerometric data showed significantly more physical activity in lessons of the “Moving school”. Rates of self-reported back or neck pain did not differ significantly between both study groups. CONCLUSION Results indicate that “Moving school” concepts are effective to change the sitting habits in elementary schoolchildren.

Assessment of pain in The Child and Adolescent Health Survey

Until now, there have been no nation-wide studies allowing a reliable estimation of the prevalence of pain in children and adolescents in Germany. In addition, data regarding the limitations and use of health care measures were also not available for children and adolescents, as well as data on influential factors that might provide valuable information on the occurrence and persistence of pain in the same epidemiological group. In the part of the survey entitled "Pain", the prevalence of pain generally as well as the features of persistent and/or recurring pain will be studied. An important result of this study shall be the first nation-wide representative figures on the prevalence of pain in general, as well as combinations of various types of pain in children and adolescents. In this way it should provide an up-to-date and representative data source to answer the following questions: How frequent is pain in children and adolescents? To what extent does pain in afflicted individuals lead to limitations? What kinds of health care measure does the individual who suffers such pain seek (medical consultation, medication)? According to the children (or their parents) or adolescents, what factors are involved in causing pain and allowing it to persist?

Are children given insufficient pain-relieving medication postoperatively?

The literature often suggests and assumes that children are under-medicated postoperatively. A review of the literature leads to the conclusion that only a few studies answer the question of whether children's pain is relieved insufficiently. The lack of consensus on expected pain intensity after surgery and caution about prescribing analgesics could explain why analgesics are often prescribed on a pro re nata (prn) basis. Prescription on a prn basis, in fact, means that the nurse makes the decision whether or not an analgesic should be administered. Some studies suggest, however, that nurses under-medicate children and that postoperative pain is relieved insufficiently. In some situations, nurses under-estimate the child's pain, while in others, nurses' attitudes, beliefs and knowledge regarding pain relief strategies play an important role. On the basis of this review of the literature standard prescription of pain medication instead of prn is recommended. Furthermore, research on the incidence and prevalence of pain in children and on the effectiveness of analgesic administration postoperatively is warranted.

Pain from Pediatric Cancer

Althoughcancer is often associated with pain, few data are available on the prevalence of pain in children with cancer. This article reports on a survey of children who were out patients of the cancer clinic at the Children's Hospital of Eastern Ontario and their parents. The goals of the study were to determine the extent of pain, as rated by the children and their parents, from three sources: from the disease, from diagnostic and monitoring procedures, and from treatment. Three-quarters of the children experienced severe pain from bone marrow aspirations, half experienced moderate to severe pain from treatment, and one-quarter had recent pain from the disease. Analgesics were not widely prescribed.