Early childhood risk factors for later onset of pediatric chronic pain

Pediatric chronic pain – pain lasting three months or longer, is a widespread, disabling, and expensive issue, particularly during adolescence. It often disrupts psychosocial development and is frequently accompanied by mental health problems. Chronic pain can emerge spontaneously without prior injuries or conditions. To better understand contributing factors, such as early pain experiences and mental health, prospective longitudinal studies are needed that follow children from early childhood before the onset of chronic pain. 

A new study utilized data from the longitudinal All Our Families (AOF) community pregnancy cohort to examine the relationship between early developmental risk factors, including early childhood pain and mental health symptoms, and the onset of chronic pain at ages 8 and 11 years.

This multi-method longitudinal study analyzed AOF data collected when children were aged 4 months and 1, 2, 3, 5, 8, and 11 years. Mothers reported their children's pain experiences, such as hospitalizations, vaccinations, and gut problems, when they were 4 months to 8 years old, chronic pain at age 8, and mental health symptoms at ages 5 and 8. Children self-reported their chronic pain frequency and its impact at age 11.

The findings suggested that gut problems, emergency room visits, frequent pain complaints, and headaches before age 5, along with female sex, were linked to a higher risk of chronic pain by age 8. Chronic pain reported by mothers at age 8 was associated with increased pain frequency and interference at age 11 – with boys reporting lower pain interference levels.

It was concluded that certain early painful experiences, such as gut problems and ER visits, contribute to the onset of pediatric chronic pain and should be considered for early screening and intervention. Identifying risk factors like female sex and persistent pain complaints is crucial for preventing chronic pain development in late childhood and early adolescence.

Source: Pavlova M, Noel M, Orr SL, et al. BMC pediatrics. 2024 Aug 8;24(1):508.