Sensory, Inflammatory, and Psychosocial Characteristics of Chronic Pain in Adolescents and Young Adults With Sickle Cell Disease.

Abstract

BackgroundChronic pain in sickle cell disease (SCD) can begin in adolescence and impair quality of life (QOL) and functioning; however, very few studies have characterized chronic SCD-related pain in this age group. This study aimed to examine the sensory, inflammatory, and psychosocial characteristics of chronic pain in adolescents and young adults (AYA) with SCD and compare them according to the three ACTTION-APS Pain Taxonomy subtypes of chronic SCD pain.MethodA cross-sectional comparative design of AYA ages 9-23 with chronic SCD pain and pain-free AYA with SCD was used. Quantitative sensory testing (QST) and psychosocial questionnaires were administered and analyzed using independent t-tests to detect differences between chronic pain and pain-free groups and analysis of variance was used to test differences between chronic pain subtypes. Salivary samples were collected for analysis of inflammatory markers IL-1β, 6, 8, 10, and TNF-α using standardized enzyme-linked immunosorbent assay kits.ResultsNineteen chronic pain participants and four pain-free controls were enrolled. Participants with chronic SCD-related pain had a significantly higher pain burden, higher mechanical pain threshold, and lower warm detection threshold (WDT) compared with pain-free AYA with SCD. Statistical differences among the three chronic pain groups and the pain-free control group in psychosocial measures and WDT were also noted.DiscussionThe findings of this study can help nurses understand chronic pain in SCD youth. This study suggests that there are unique characteristics of chronic SCD-related pain in youth with varying disabilities and psychosocial needs; additional research is needed to explore these differences further.