Pain extent and function in youth with physical disabilities

Jordi Miró,1–4 Rocío de la Vega,1,5 Catarina Tomé-Pires,1–3 Elisabet Sánchez-Rodríguez,1–3 Elena Castarlenas,1–3 Mark P Jensen,5 Joyce M Engel,6 1Unit for the Study and Treatment of Pain – ALGOS, Universitat Rovira i Virgili, Catalonia, Spain; 2Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain; 3Institut d’Investigació Sanitària Pere Virgili, Catalonia, Spain; Universitat Rovira i Virgili, Catalonia, Spain; 4Chair in Pediatric Pain, Universitat Rovira i Virgili-Fundación Grünenthal, Catalonia, Spain; 5Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA; 6Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA 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 ( =12.7, SD ±9.5, range 0–60) or global pain intensity ( =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