Related Experiment Video
Updated: Feb 22, 2026
Electrophysiological Measurements and Analysis of Nociception in Human Infants
Published on: December 20, 2011
Measuring Musculoskeletal Pain in Infants, Children, and Adolescents
Insights
Accurate pain assessment in children is challenging but crucial for effective musculoskeletal pain management. This review offers clinicians tools and strategies for reliable pain measurement in pediatric patients, including those with cognitive impairments.
Area of Science:
- Pediatric Pain Management
- Musculoskeletal Conditions
- Clinical Assessment Tools
Background:
- Effective management of musculoskeletal pain relies on accurate pain assessment.
- Assessing pain in infants, children, and adolescents, especially those with cognitive impairments, presents significant clinical challenges.
- Factors influencing pain assessment include consultation dynamics, clinician knowledge, scale properties, patient development, and environmental context.
Purpose of the Study:
- To provide clinicians with an overview of pain assessment scales for infants, children, and adolescents.
- To review approaches for measuring pain intensity in pediatric populations.
- To identify factors affecting pain experience, expression, and assessment, and suggest age-appropriate measurement strategies.
Main Methods:
- Review of various pain intensity measurement approaches.
- Identification of factors influencing pain assessment in pediatric patients.
- Examination of age-appropriate pain intensity measurement scales for patients with and without cognitive impairment.
- Assessment of multidimensional pain scales for evaluating pain impact.
Main Results:
- Pain in pediatric populations is often underassessed and undertreated due to various challenges.
- A range of pain assessment scales exist, varying in psychometric properties and applicability.
- Multidimensional scales can assess the broader impact of pain beyond intensity.
Conclusions:
- Clinicians need comprehensive knowledge of available pain assessment tools for pediatric patients.
- Tailored approaches are necessary for accurate pain measurement across different developmental stages and cognitive abilities.
- Improved pain assessment can lead to more effective pain management in children and adolescents.
Abstract:
Synopsis Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state). As a result, pain is frequently not assessed or measured during the consultation and, in many instances, underestimated and undertreated in this population. The purpose of this article is to provide clinicians with an overview of scales that may be used to measure pain in infants, children, and adolescents. Specifically, the paper reviews the various approaches to measure pain intensity; identifies factors that can influence the pain experience, expression, and assessment in infants, children, and adolescents; provides age-appropriate suggestions for measuring pain intensity in patients with and without cognitive impairment; and identifies ways to assess the impact of pain using multidimensional pain scales. J Orthop Sports Phys Ther 2017;47(10):712-730. doi:10.2519/jospt.2017.7469.
