Musculoskeletal pain in children and adolescents: Implications for a painful future

Tie P. Yamato, Veronica S. Santos, Mariana N. Leite, Caique M. E. Santo, Caio S.Vallio, Aidan Cashin, Christopher Williams, Bruna A. Hatakeyama, Barbara I. A. Camargo, Tuyra F. C. Silva, Fabiana R. de Jesus-Moraleida, Leonardo O. P. Costa, Luiz C. Hespanhol, Gisela C. Miyamoto, Chris Maher, Steve Kamper
Purpose:

This presentation will outline our present knowledge of MSK pain in children and adolescents (referred to as kids), examining its prevalence, incidence, progression, impact, and the associated costs based on recent research findings.

Methods:

Study 1 is a cross-sectional investigation involving kids who provided self-reports on pain, psychosomatic symptoms, and their quality of life. Study 2 is a prospective cohort study aimed at estimating the economic burden of pain in kids over a one-year period, including an assessment of the national budgetary impact. Study 3 is an 18-month longitudinal cohort study involving kids who did not report pain at the start. The study explored the incidence of pain and identified predictive factors for its onset. Study 4, also an 18-month longitudinal cohort study, focused on children experiencing pain, where recovery rates were tracked, and a model predicting recovery was tested.

Results:

Study 1 involved 2,688 kids and found that 27% experienced disabling musculoskeletal (MSK) pain within the past month, with the back being the most commonly affected area (51.8%). Factors linked to the presence of pain included higher body weight, strained family relationships, perceived backpack heaviness, negative psychosomatic symptoms, lower quality of life, and higher pain intensity. Study 2 followed 237 kids over 12 months, revealing an annual societal cost of US$177.62 per child, with a national budgetary impact estimated at US$1 billion per year. Study 3, which included 1,994 children, found an 18-month incidence of disabling MSK pain of 22.6%. The predictive model effectively identified those at higher risk of developing disabling MSK pain. Study 4, with 694 participants, demonstrated a recovery rate of 85.9% and a recurrence rate of 31.7%. The prediction model was successful in identifying those most likely to recover from disabling MSK pain.

Conclusion(s):

This collection of evidence emphasizes that musculoskeletal (MSK) pain is both common and disabling in children. The findings indicate that while the condition imposes significant costs, there is a high rate of recovery, though recurrence remains a concern.

Implications:

These results highlight the pressing need for targeted interventions to alleviate the burden of pain early in life, offering potential benefits for individuals, families, and healthcare systems both now and in the long term.

Funding acknowledgements:
This work was funded by the Sao Paulo Research Foundation (FAPESP-Brazil: 2017/17484-1).
Keywords:
Pain
Musculoskeletal
Children and Adolescents
Primary topic:
Pain and pain management
Second topic:
Musculoskeletal
Third topic:
Paediatrics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This work was approved by the Research Ethics Committee of the Universidade Cidade de Sao Paulo.
Provide the ethics approval number:
CAAEs: 18752219.0000.0064
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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