The natural course of chronic benign pain in childhood and adolescence: a two-year population-based follow-up study

STUDY OBJECTIVE: To assess the course of chronic benign pain in childhood and adolescence longitudinally.Setting. Cohort of children with chronic pain recruited from the open population.

PATIENTS: A cohort of 987 children and adolescents aged 0-18 years with chronic pain (continuous or recurrent pain>3 months), who were identified in a previous population-based prevalence study, were approached for a two-year follow-up study. Subjects were asked to keep a 3-week diary on their pain and to fill out questionnaires about background factors, pain and pain-related consequences. This assessment was repeated annually for two years.

RESULTS: At baseline, 254 subjects reported chronic benign pain; of these, 124 (48%) and 77 (30%) subjects still experienced chronic benign pain at one-year and two-year follow-up, respectively. Except for the estimated pain intensity, which decreased marginally, pain remained stable over the follow-up period. Minor changes occurred in the consequences of pain; the main changes were a decrease of the impact of pain on the child's behavior, social functioning and use of health care. Subjects with persistent pain (9.4%) differed from those with non-persistent pain in frequency, history and location of the pain, emotional problems and their mother's health.

CONCLUSIONS: Chronic benign pain in childhood and adolescence is common, and seems to persist in a considerable proportion (30-45%), although pain generally does not deteriorate over time.