Somatosensory Function and Pain: Associations Over 12 Months Postinjury in Youth With Acute Musculoskeletal Pain

Acute musculoskeletal (MSK) injuries are common in youth and prior research has identified somatosensory experiences such as conditioned pain modulation (CPM) as a predictor of the transition from acute to chronic pain. Prior pediatric studies are limited by small samples, single quantitative sensory testing (QST) modalities, and short-term follow-up, so the utility of QST in predicting longer-term pain outcomes following acute injury is unknown. To fill this gap, we examined somatosensory function in the acute pain period as a predictor of pain outcomes over 12 months.

Participants were 226 youth (and a caregiver) taking part in a prospective longitudinal study. Youth completed a QST battery (pain threshold, pain tolerance, temporal summation, and CPM) at baseline (postinjury), and questionnaires assessing pain (average pain, movement-evoked pain; MEP) at 3 time points over 12 months.

A subset of youth developed persistent pain (≥3/0 to 10 NRS) at 3 months (15% to 21% depending on pain measure). Regression models indicated CPM was the sole QST measure that predicted pain intensity and persistence at 3 months (both average and MEP). No QST measures predicted pain outcomes at 12 months. Female sex was associated with pain persistence in multiple models.

CPM in the acute pain period is a potential marker for short-term pain outcomes. Future research can examine the utility of using QST in predicting pain outcomes in other pediatric pain samples (eg, non-MSK locations, more severe injuries) and can expand assessment of MEP using standardized performance tasks.