Journal of Pain Research (Feb 2023)
The Psychosocial Characteristics and Somatosensory Function of Children and Adolescents Who Meet the Criteria for Chronic Nociplastic Pain
Abstract
Don Daniel Ocay,1– 3 Brendan D Ross,4 Lorenzo Moscaritolo,3 Nabeel Ahmed,4 Jean A Ouellet,2,5– 7 Catherine E Ferland,1– 3,6– 8,* Pablo M Ingelmo3,6– 8,* 1Department of Experimental Surgery, McGill University, Montreal, QC, Canada; 2Department of Clinical Research, Shriners Hospitals for Children Canada, Montreal, QC, Canada; 3Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 4Faculty of Medicine, McGill University, Montreal, QC, Canada; 5Department of Pediatric Surgery, McGill University, Montreal, QC, Canada; 6Department of Anesthesia, McGill University, Montreal, QC, Canada; 7Research Institute-McGill University Health Centre, Montreal, QC, Canada; 8Alan Edwards Research Center for Pain, McGill University, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Pablo M Ingelmo, Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children’s Hospital, B02-3525-1001 Boulevard Décarie, Montreal, H4A 13J, Canada, Tel +1 514 412-4448, Fax +1 514 412-4341, Email [email protected]: Nociplastic pain distinguishes individuals with pain and hypersensitivity in body regions with apparently normal tissues, without any signs of neuropathy, but with contribution of central and/or peripheral sensitization. There is a lack of literature describing nociplastic pain in the pediatric population. The objective of this study was to investigate the differences between pediatric patients with nociplastic pain compared with patients with non-nociplastic pain.Patients and Methods: This study included 414 pediatric patients followed at an interdisciplinary centre for complex pain. All patients underwent an exhaustive pain assessment consisting of face-to-face interviews, validated self-report questionnaires and quantitative sensory testing. Recently established criteria for chronic nociplastic pain, and quantitative sensory testing was used to describe and stratify our cohort.Results: One hundred and sixty-five patients (40%) were stratified as having possible nociplastic pain and two hundred and forty-nine (60%) patients, as non-nociplastic pain. Patients with nociplastic pain displayed pain hypersensitivity in the region of pain, more symptoms of panic and social phobia, and worse sleep quality than patients with non-nociplastic pain. The proportion of patients achieving a meaningful clinical outcome after completion of their treatment (medications, physiotherapy, psychology, nursing, social worker, and/or interventional procedures) was lower in patients with nociplastic pain (62%) than those without nociplastic pain (86%).Conclusion: Our results suggest that patients who meet the criteria for nociplastic pain can be identified in a population of children and adolescents being treated in a center for complex pain. Combining screening with validated questionnaires and quantitative sensory testing facilitates the phenotyping and graded severity of patients with nociplastic pain in daily clinical practice.Keywords: nociplastic pain, chronic pain, children, adolescents, quantitative sensory testing
