Predicting the onset of widespread body pain among children

Objective. To determine factors associated with, and the predictors of, widespread body pain in children.

Methods. A population-based prospective study was conducted among school children in Northwest England. At baseline, subjects completed a self-report questionnaire on widespread body pain. Information was collected on behavioral and emotional factors, other somatic symptoms, and measures of physical activity/ inactivity. Children who were free of widespread pain were contacted again 12 months later to determine any new onset of widespread pain. Regression analyses were used to identify the factors that were associated with the reporting of widespread pain at baseline, and to determine the factors that predicted the new onset of symptoms at followup among those children free of widespread pain at baseline. Results were expressed as relative risks (RR) with 95% confidence intervals (95% CI).

Results. A total of 1,440 children (96%) agreed to participate in the survey at baseline, and of those eligible, 1,081 (88%) participated at followup. The reporting of widespread pain (prevalence 14.6%) and its new onset at the 12-month followup (prevalence 7.7%) was common. At baseline, symptoms were associated with adverse behavioral and emotional factors (RR 2.5, 95% CI 1.8-3.6), with the report of other common childhood somatic symptoms (e.g., frequent headache; RR 3.5, 95% CI 2.2-5.5), and with high levels of sports activity (RR 1.9, 95% CI 1.3-2.9). Furthermore, all of these factors (in the absence of widespread pain at baseline) increased the likelihood of symptom onset at followup.

Conclusion. Children who report behavioral problems or other somatic symptoms are at increased risk, at least in the short term, of developing chronic widespread pain. It remains to be determined whether these are long-term risk factors for the onset of such symptoms, and whether they could be predictors of the development of other functional syndromes.