Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures.

Abstract

Purpose: This study addressed conflicting evidence regarding pain in adolescents with adolescent idiopathic scoliosis (AIS) by assessing its prevalence and consequences on physical function, and psychosocial well-being in our patients.

Methods: 95 patients with AIS participated in a cross-sectional, observational study. Patient information, clinical and radiographic measures were collected. Participants completed four pain-related patient-reported outcomes (PROs) along with physical function and psychosocial PROs. Means, standard deviations (SD), interquartile ranges (IQR), and ceiling/floor percentages were calculated for each pain-related PRO. Pain prevalence was defined as percentage of participants exceeding one SD and percentage of participants above two SD of published normative values. Correlations assessed associations between pain-PRO scores and scores on other study measures. Differences in PRO scores between High Pain (HP) and Remaining Cohort (RC) groups, established through interquartile thresholds, were assessed via ANOVA and Cohen's d.

Results: Cohort mean age was 14.1 ± 1.7 years, and mean curve magnitude of primary curve was 33 ± 13°. Pain prevalence ranged from 1 to 37% depending on the pain-related PRO. HP groups scored worse on physical function and psychosocial PROs than RC, but no differences between the groups were found for clinical measures.

Conclusion: Relationships among pain, physical function, psychosocial well-being PRO scores, and clinical measures were established but causality could not be demonstrated. Most patients did not report pain. HP patients scored lower on physical function and psychosocial well-being PROs. HP threshold values can be used to identify HP patients so that interventions to reduce pain can be incorporated into their treatment plan.