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Pain site persistence and changes from childhood to adolescence: a prospective cohort study

  • Population Study Article
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Abstract

Background

Pain is a complex experience that interferes with the well-being of youth who experience it. We aimed to assess whether recurrent pain sites in childhood can predict later recurrent pain sites prospectively.

Methods

Pain was assessed using the Luebeck Pain Screening Questionnaire at ages 7, 10, and 13 from the Generation XXI cohort. We used multinomial regression to assess the association of recurrent pain sites at ages 7 and 10 with those at age 13.

Results

We included 3833 participants. Boys with recurrent abdominal/pelvic pain at age 7 were more likely to report headaches (OR 2.81; 95%CI 1.48–5.34), abdominal/pelvic (OR 2.92; 95%CI 1.46–5.84), and musculoskeletal pain (OR 1.55; 95%CI 1.02–2.34) at age 13. Girls with recurrent abdominal/pelvic pain at age 7 were more likely to report both musculoskeletal (OR 1.62; 95%CI 1.10–2.40) and abdominal/pelvic pain (OR 1.74; 95%CI 1.15–2.65). At age 10, all pain sites were associated with pain in the same site at age 13.

Conclusion

Recurrent abdominal/pelvic pain at age 7 may be related to the development of various pains in adolescence. Pain at a given site at age 10 can be associated with pain at that same site at age 13.

Impact

  • Recurrent abdominal or pelvic pain during childhood was distinctively associated with an increased risk of recurrent pain in other sites during adolescence.

  • Recurrent pain during childhood was associated with pain in the same sites at age 13, and this persistence seemed to emerge between the ages of 7 and 10 for both boys and girls.

  • Studying early pain sites may add to the understanding of the etiology of chronic pain.

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Fig. 1
Fig. 2: Odds Ratios and 95% confidence intervals of recurrent pain in specific anatomical groups at age 13, given the recurrent pain topography at ages 7 and 10, for boys.
Fig. 3: Odds Ratios and 95% confidence intervals of recurrent pain in specific anatomical groups at age 13, given the recurrent pain topography at ages 7 and 10, for girls.

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Data availability

The data that support the findings of this study are available from the 21 cohort (https://www.geracao21.com/en/) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the G21 Coordination Board.

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Acknowledgements

The authors gratefully acknowledge the families enrolled in G21 for their kindness and dedication, all research team members for their enthusiasm and perseverance, and the participating hospitals and their staff for their help and support. The authors would also like to express their sincere gratitude to Maria Brandão for her valuable contributions in the conceptualization of this manuscript. This work was supported by FOREUM – Foundation for Research in Rheumatology (Career Research Grant). This work is supported by the Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UIDB/04750/2020) and Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR) (LA/P/0064/2020), Administração Regional de Saúde Norte (Regional Department of Ministry of Health) and Fundação Calouste Gulbenkian. M.T. was funded by the ERDF, through the North Regional Operational Program in the framework of the project HEALTH-UNORTE (NORTE-01-0145-FEDER-000039).

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Authors and Affiliations

  1. EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal

    Francisco Fernandes, Makram Talih, Catarina Pires, Naré Navasardyan & Raquel Lucas

  2. Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal

    Francisco Fernandes, Makram Talih, Catarina Pires, Naré Navasardyan & Raquel Lucas

  3. Unidade de Saúde Pública – Agrupamento de Centros de Saúde Baixo Mondego, Coimbra, Portugal

    Francisco Fernandes

  4. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    Makram Talih

  5. Rheumatology Department, Hospital Garcia de Orta EPE, Almada, Portugal

    Maria José Santos

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  1. Francisco Fernandes
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Contributions

All authors of this study made significant contributions to the conception and design, or data analysis, and interpretation of the results. The initial draft of the manuscript was prepared by F.F., and subsequent revisions for important intellectual content were made by M.T., C.P., N.N., M.J.S., and R.L.; Finally, all authors provided the final approval of the manuscript for publication.

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Correspondence to Francisco Fernandes.

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Written informed consent was obtained from legal guardians at baseline and follow-up visits. Oral assent from children was obtained in follow-up visits.

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Fernandes, F., Talih, M., Pires, C. et al. Pain site persistence and changes from childhood to adolescence: a prospective cohort study. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03021-w

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