Chronic musculoskeletal pain in childhood

We studied 73 children with chronic or recurrent musculoskeletal pain of gr eater than or equal to 6 weeks' duration. Thirty-six children had no identi fiable organic etiology for their pain, with a minimum follow-up of 2 years for ongoing symptoms. Thirty-seven children had an organic etiology for th eir pain. Use of an Inappropriate Symptom Checklist was helpful in distingu ishing between children with chronic pain who were found to have an organic disease and those without an identifiable organic disease. Seventy-seven p ercent of children with no inappropriate symptoms had an organic diagnosis ultimately made. Conversely, 79% of children with two or more inappropriate symp toms ultimately had no organic diagnosis to explain their pain. Behav ioral self-report measures testing could not differentiate between children with chronic pain with or without organic disease. Intervention by a psych ologist skilled in pain manage ment was helpful.