Chronic musculoskeletal pain in childhood
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Published on: August 13, 2015
K M Song1, A A Morton, K D Koch
1Department of Orthopedic Surgery, Children's Hospital and Medical Center of Seattle, Washington 98105-0371, USA.
Insights
An Inappropriate Symptom Checklist aids in diagnosing chronic musculoskeletal pain in children. It helps differentiate organic causes from non-organic pain, unlike behavioral self-report measures.
Area of Science:
- Pediatric Rheumatology
- Child Psychology
- Pain Management
Background:
- Chronic or recurrent musculoskeletal pain affects many children, with varying underlying causes.
- Differentiating organic from non-organic pain is crucial for effective treatment and management.
- Existing diagnostic tools may not adequately distinguish between these pain etiologies in pediatric populations.
Purpose of the Study:
- To evaluate the utility of an Inappropriate Symptom Checklist (ISC) in differentiating pediatric chronic musculoskeletal pain with and without an organic etiology.
- To compare the effectiveness of the ISC with behavioral self-report measures in diagnosis.
- To assess the impact of psychologist intervention for children with chronic pain.
Main Methods:
- A cohort of 73 children with chronic musculoskeletal pain (duration > or = 6 weeks) was studied.
- Children were categorized based on the presence or absence of an identifiable organic etiology for their pain.
- The Inappropriate Symptom Checklist and behavioral self-report measures were administered; follow-up data were collected.
Main Results:
- The Inappropriate Symptom Checklist demonstrated utility in distinguishing between organic and non-organic pain.
- Children with no inappropriate symptoms had a high likelihood (77%) of an organic diagnosis.
- Conversely, children with two or more inappropriate symptoms were likely (79%) to have no organic diagnosis; behavioral measures were not differentiating.
Conclusions:
- The Inappropriate Symptom Checklist is a valuable tool for pediatricians and rheumatologists in the diagnostic process for chronic musculoskeletal pain.
- Psychologist intervention, particularly by specialists in pain management, can be beneficial for children experiencing chronic pain.
- Further research may explore integrating the ISC into routine clinical practice for improved diagnostic accuracy.
Abstract:
We studied 73 children with chronic or recurrent musculoskeletal pain of > or = 6 weeks' duration. Thirty-six children had no identifiable organic etiology for their pain, with a minimum follow-up of 2 years for ongoing symptoms. Thirty-seven children had an organic etiology for their pain. Use of an Inappropriate Symptom Checklist was helpful in distinguishing between children with chronic pain who were found to have an organic disease and those without an identifiable organic disease. Seventy-seven percent of children with no inappropriate symptoms had an organic diagnosis ultimately made. Conversely, 79% of children with two or more inappropriate symptoms ultimately had no organic diagnosis to explain their pain. Behavioral self-report measures testing could not differentiate between children with chronic pain with or without organic disease. Intervention by a psychologist skilled in pain management was helpful.
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