• Lewandowski HolleyAmyA*Institute on Development & Disability, Oregon Health & Science University, Portland, OR †Seattle Children's Research Institute ‡Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA., Anna C Wilson, Elise Cho, and Tonya M Palermo.
• *Institute on Development & Disability, Oregon Health & Science University, Portland, OR †Seattle Children's Research Institute ‡Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
• Clin J Pain. 2017 Jan 1; 33 (1): 283628-36.

ObjectivesThe course of pediatric musculoskeletal pain from acute to chronic has not been well described and there is limited understanding of how to identify individuals with new-onset pain who may be predisposed to developing persisting symptoms. Thus, the purpose of this study was to describe the clinical phonotype of treatment-seeking youth with new-onset musculoskeletal pain compared with youth with and without chronic pain. Further, we tested predictors of pain-related disability and pain sensitivity in the new-onset pain sample.MethodsParticipants were 191 youth, ages 10 to 17 years, representing 3 cohorts (new-onset musculoskeletal pain, chronic musculoskeletal pain, and a comparison group without chronic pain). Participants completed questionnaire measures of pain characteristics, psychological functioning, sleep, and pain-related disability. They also attended a laboratory visit to complete an experimental pain assessment using heat and cold stimuli to assess pain sensitivity and conditioned pain modulation.ResultsFindings revealed youth with new-onset musculoskeletal pain had a distinct clinical phenotype where symptoms of pain and disability were in the mid-range between those of youth with diagnosed chronic musculoskeletal pain and youth in the community without chronic pain. Linear regressions within the new-onset pain sample demonstrated poorer sleep quality and higher pain fear predicted greater pain-related disability, and pain catastrophizing predicted cold pressor sensitivity.DiscussionClinical phenotyping of youth with new-onset musculoskeletal pain highlights factors relevant to the pain experience. Future research can examine the roles of these variables in predicting longitudinal risk for chronic pain and disability.

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