Background Musculoskeletal pain is one of the most common complaints of the children referred to general pediatricians. Children and adolescents with chronic pain frequently report sleep disturbances, reduced participation in social activities and school absence. So, pain greatly affects their overall sense of wellbeing and impairs their daily functioning and quality of life (QOL).
Objectives In the present study, we aimed to determine the prevalence of chronic widespread pain and its relation with fatigue, sleep disturbance, chronic headache, school performance, depression, and QOL in the children and adolescents.
Methods A cross-sectional study was conducted in middle schools and high schools. The students were asked about the socio-demographic characteristics, pain, fatigue, sleep disturbance, chronic headache, school performance, depression, and QOL. Pain of the children was assessed by Visual Analogue Scale (VAS) pain score. Depressive symptoms were evaluated with the Children's Depression Inventory (CDI). The number of days absent from school as a result of pain during the one month prior to the date of the assessment was reported. The average grade of the previous year for each child was obtained from the school administration. Quality of life was evaluated with the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0).
Results The study group consisted of 1109 children (mean age 14.8±2.0 years old), 549 (49.5%) boys and 560 (50.5%) girls. On hundred and twenty-six of 1109 children (11.4%) had widespread pain lasting three months or more. 95 of the girls (17%) and 31 of boys (5.6%) had widespread pain with a statistical difference (p<0.001). VAS pain score was 0.80±1.72 (min-max, 0-10) and duration of pain was 2±7.40 months, (min-max, 0-96). While 493 of 1109 children (44.5%) had fatigue, 271 (24.4%) had sleep disturbance, and 130 (11.7%) had chronic headache, the children who had widespread pain reported more fatigue (88.9%), sleep disturbance (55.6%) and headache (41.3%) than the children without pain (p<0.001, for all). Sixteen (12.7%) of the children having chronic pain reported a psychiatric disorder and 6 (4.8%) reported a rheumatic disease in the medical history. The CDI total score was 9.32±6.24, and 100 (9.01%) of the children had a score over 19 which is the cutoff score for depression. PedsQL physical health, psychosocial health and total score were 79.83±16.23, 80.65±17.52, 80.24±14.56, respectively. The school absences were 0.38±1.04 days of school per month, the school grade was 3.87±1. The children with pain also demonstrated higher school absences, CDI score, and lower PedsQL scores than the children without pain. While there was positive correlation between VAS pain score and school absences and CDI total score, it was negatively correlated with school grade, PedsQL physical health, psychosocial health and the total score.
Conclusions We found the prevalence of chronic pain 11.4% in the school children. Children and adolescents with chronic pain were shown to report a significantly higher frequency of fatigue, sleep difficulties and chronic headache. Chronic pain was also found related with depressive symptoms, school performance and quality of life. To prevent the development of chronic pain and to carry into adulthood, it is important to recognize and treat musculoskeletal pain as early as possible.
Disclosure of Interest None declared