Pain extent and function in youth with physical disabilities

Abstract

Background

The aim of this study was to increase our understanding of the role that spatial qualities of pain (location and extent) play in functioning, among youths with disabilities and chronic pain.

Methods

One-hundred and fifteen youths (mean age 14.4 years; SD ±3.3 years) with physical disabilities and chronic pain were interviewed and were asked to provide information about pain locations and their average pain intensity in the past week, and to complete measures of pain interference, psychological function and disability. Most of the participants in this sample were males (56%), Caucasian (68%), and had a cerebral palsy (34%) or muscular dystrophy (25%) problem. Most participants did not report high levels of disability ($\overline{X}=12.7$, SD ±9.5, range 0–60) or global pain intensity ($\overline{X}=3.2$, SD ±2.4, range 0–10).

Results

Pain at more than one body site was experienced by 91% of participants. There were positive associations between pain extent with pain interference (r = 0.30) and disability (r = 0.30), and a negative association with psychological function (r = –0.38), over and above average pain intensity. Additionally, pain intensity in the back (as opposed to other locations) was associated with more pain interference (r = 0.29), whereas pain intensity in the shoulders was associated with less psychological function (r = –0.18), and pain intensity in the bottom or hips was associated with more disability (r = 0.29).

Conclusion

The findings support the need to take into account pain extent in the assessment and treatment of youths with physical disabilities and chronic pain, call our attention about the need to identify potential risk factors of pain extent, and develop and evaluate the benefits of treatments that could reduce pain extent and target pain at specific sites.

Keywords:

• pain extent
• pediatric chronic pain
• physical disability
• function

Acknowledgments

Support for the study upon which the findings reported here are based was provided by Grant P01 ND/NS 33988 from the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke, National Institutes of Health.

Financial support for this work was provided, in part, by grants from Obra Social de Caixabank, Universitat Rovira i Virgili (PFR Program), Spanish Ministry of Economy and Competitiveness (MINECO; PSI2012-32471, PSI2015-70966-P). Rocío de la Vega’s work is supported by a Beatriu de Pinós Postdoctoral Fellowship (2014 BP-A 00009) granted by the Agency for Administration of University and Research Grants (AGAUR). Rocío de la Vega’s travel is supported by the grant R2B (grant for the enhancement of knowledge) by the Universitat Rovira i Virgili. Elena Castarlenas’ work is supported by grant PSI2014-60180-JIN of the Spanish Ministry of Economy and Competitiveness. Jordi Miró’s work is also supported by the Institució Catalana de Recerca i Estudis Avançats (ICREA-Acadèmia), and Fundación Grünenthal.

Disclosure

The authors report no conflicts of interest in this work.