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Pain among children and adolescents:
restrictions in daily living and triggering factors |
OBJECTIVES: Pain among children and adolescents has
been identified as an important public health problem. Most studies
evaluating recurrent or chronic pain conditions among children have been
limited to descriptions of pain intensity and duration. The effects of
pain states and their impact on daily living have rarely been studied. The
objective of this study was to investigate the impact of perceived pain on
the daily lives and activities of children and adolescents. In addition,
we sought to delineate self-perceived triggers of pain among children and
adolescents. In this study, we (1) document the 3-month prevalence of
painful conditions among children and adolescents, (2) delineate their
features (location, intensity, frequency, and duration), (3) describe
their consequences (restrictions and health care utilization), and (4)
elucidate factors that contribute to the occurrence of pain episodes among
young subjects. METHODS: The study was conducted in 1 elementary school
and 2 secondary schools in the district of Ostholstein, Germany. Children
and adolescents, as well as their parents/guardians, were contacted
through their school administrators. The teachers distributed an
information leaflet, explaining the conduct and aim of the study, to the
parents a few days before the official enrollment of the youths in the
study. Parents of children in grades 1 to 4 of elementary school were
asked to complete the pain questionnaire for their children at home,
whereas children from grade 5 upward completed the questionnaire on their
own during class, under the supervision of their teachers. The response
rate was 80.3%. As previously stated, chronic pain was defined as any
prolonged pain that lasted a minimum of 3 months or any pain that recurred
throughout a minimal period of 3 months. The children and adolescents were
surveyed with the Luebeck Pain-Screening Questionnaire, which was
specifically designed for an epidemiologic study of the characteristics
and consequences of pain among children and adolescents. The questionnaire
evaluates the prevalence of pain in the preceding 3 months. The body area,
frequency, intensity, and duration of pain are addressed by the
questionnaire. In addition, the questionnaire inquires about the private
and public consequences of pain among young subjects. Specifically, the
questionnaire aims to delineate the self-perceived factors for the
development and maintenance of pain and the impact of these conditions on
daily life. RESULTS: Of the 749 children and adolescents, 622 (83%) had
experienced pain during the preceding 3 months. A total of 30.8% of the
children and adolescents stated that the pain had been present for >6
months. Headache (60.5%), abdominal pain (43.3%), limb pain (33.6%), and
back pain (30.2) were the most prevalent pain types among the respondents.
Children and adolescents with pain reported that their pain caused the
following sequelae: sleep problems (53.6%), inability to pursue hobbies
(53.3%), eating problems (51.1%), school absence (48.8%), and inability to
meet friends (46.7%). The prevalence of restrictions in daily living
attributable to pain increased with age. A total of 50.9% of children and
adolescents with pain sought professional help for their conditions, and
51.5% reported the use of pain medications. The prevalence of doctor
visits and medication use increased with age. Weather conditions (33%),
illness (30.7%), and physical exertion
(21.9%) were the most frequent self-perceived triggers for pain noted by
the respondents. A total of 30.4% of study participants registered
headache as the most bothersome pain, whereas 12.3% cited abdominal pain,
10.7% pain in the extremities, 8.9% back pain, and 3.9% sore throat as
being most bothersome. A total of 35.2% of children and
Pediatrics (Online); 2005 Feb 1;115(2)
Author(s): Roth-Isigkeit A; Thyen U; Stöven H
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