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Body mass in adolescents with chronic pain: observational study
Jeremy Gauntlett-Gilbert1,2, Chandrika Bhat3, Jacqui Clinch4,3
1Bath Centre for Pain Services, Royal United Hospital Bath NHS Trust, Bath, UK jeremy.gauntlett-gilbert@nhs.net.
Objective:
In a paediatric chronic pain population, to determine whether higher body mass was associated with poorer functioning, mood or treatment outcome.
Design:
Cross-sectional study with examination of treatment outcomes.
Setting:
Tertiary specialist adolescent pain rehabilitation unit.
Patients:
355 adolescents with relatively severe non-malignant chronic pain.
Interventions:
Intensive 3-week pain rehabilitation programme.
Main Outcome Measures:
Objective physical measures (walk, sit-to-stand); self-reported functioning and mood RESULTS: Average body mass index (BMI) in the sample was relatively high (24.2 (SD 5.6)) with 20.5% being classified as obese. However, there were no relationships between body mass and objective physical measures, physical or social functioning, depression or anxiety (all p>0.05). There was a small relationship between higher body mass and greater pain-related fear (r=0.17, p<0.01). Treatment improved all variables (p<0.001) apart from pain intensity. There were no relationships between higher body mass and poorer treatment outcome; in fact, patients with higher BMI showed slightly greater decreases in depression (r=0.12, p<0.05) and pain-specific anxiety (r=0.18, p<0.01) during treatment.
Conclusions:
Higher body mass does not worsen functioning, mood or treatment response in adolescents with disabling chronic pain. Childhood obesity and chronic pain are both stigmatised conditions; clinicians should avoid implying that high body mass alone is a causal factor in the struggles of a young person with chronic pain.
