4.4 Article

Reports of Chronic Pain in Childhood and Adolescence Among Patients at a Tertiary Care Pain Clinic

Journal

JOURNAL OF PAIN
Volume 14, Issue 11, Pages 1390-1397

Publisher

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2013.06.010

Keywords

Chronic pain; pediatric pain; fibromyalgia; anxiety; depression; functional status

Funding

  1. Department of Anesthesiology, University of Michigan Medical School

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Although chronic pain in childhood can last into adulthood, few studies have evaluated the characteristics of adults with chronic pain who report childhood chronic pain. Thus, 1,045 new patients (mean age, 49.5 +/- 15.4) at an academic tertiary care pain clinic were prospectively evaluated using validated self-report questionnaires. Patients also responded to questions about childhood pain. We found that almost 17% (n = 176) of adult chronic pain patients reported a history of chronic pain in childhood or adolescence, with close to 80% indicating that the pain in childhood continues today. Adults reporting childhood chronic pain were predominantly female (68%), commonly reported widespread pain (85%), and had almost 3 times the odds of meeting survey criteria for fibromyalgia (odds ratio ION = 2.94, 95% confidence interval [CI] = 2.04-4.23) than those denying childhood chronic pain. Similarly, those with childhood pain had twice the odds of having biological relatives with chronic pain (OR = 2.03, 95% Cl = 1.39-2.96) and almost 3 times the odds of having relatives with psychiatric illness (OR = 2.85, 95% Cl = 1.97-4.11). Lastly, compared to patients who did not report childhood chronic pain, those who did were more likely to use neuropathic descriptors for their pain (OR = 1.82, 95% Cl = 1.26-2.64), have slightly worse functional status (B = 2.12, t = 3.10, P = .002), and have increased anxiety (OR = 1.77, 95% Cl = 1.24-2.52). Perspective: Our study revealed that 1 in 6 adult pain patients reported pain that dated back to childhood or adolescence. In such patients, evidence suggested that their pain was more likely to be widespread, neuropathic in nature, and accompanied by psychological comorbidities and decreased functional status. (C) 2013 by the American Pain Society

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