Somatosensory Function and Pain: Associations Over 12 Months Postinjury in Youth With Acute Musculoskeletal Pain.

Abstract

Objective: Acute musculoskeletal (MSK) injuries are common in youth and prior research has identified somatosensory experiences such as conditioned pain modulation (CPM) as a predictor of the transition from acute to chronic pain. Prior pediatric studies are limited by small samples, single quantitative sensory testing (QST) modalities, and short-term follow-up, so the utility of QST in predicting longer-term pain outcomes following acute injury is unknown. To fill this gap, we examined somatosensory function in the acute pain period as a predictor of pain outcomes over 12 months.

Methods: Participants were 226 youth (and a caregiver) taking part in a prospective longitudinal study. Youth completed a QST battery (pain threshold, pain tolerance, temporal summation, and CPM) at baseline (postinjury), and questionnaires assessing pain (average pain, movement-evoked pain; MEP) at 3 time points over 12 months.

Results: A subset of youth developed persistent pain (≥3/0 to 10 NRS) at 3 months (15% to 21% depending on pain measure). Regression models indicated CPM was the sole QST measure that predicted pain intensity and persistence at 3 months (both average and MEP). No QST measures predicted pain outcomes at 12 months. Female sex was associated with pain persistence in multiple models.

Discussion: CPM in the acute pain period is a potential marker for short-term pain outcomes. Future research can examine the utility of using QST in predicting pain outcomes in other pediatric pain samples (eg, non-MSK locations, more severe injuries) and can expand assessment of MEP using standardized performance tasks.