Widespread pain and neck pain in schoolchildren. A prospective one-year follow-up study

The aims of this study were to prospectively follow up population-based coh orts of children with widespread pain, children with neck pain and pain-fre e children, in order to evaluate 1-y changes in pain symptoms and to evalua te predictors for persistent widespread pain and for the change of neck pai n to widespread pain. A structured pain questionnaire, the Children's Depre ssion Inventory, and a sleep questionnaire were completed by the pre-adoles cent cohorts, and clinical evaluation with tender point palpation and pain threshold measurements was carried out in both years. The Child Behavior Ch ecklist, the Teacher's Report Form and a sociodemographic questionnaire wer e completed at baseline. More children in the 2 pain cohorts reported pain at follow-up than did controls (p < 0.0001). Children with persistent wides pread pain had lower pain thresholds compared with those whose pain classif ication changed. In the neck pain group, 19 (20.4%) reported widespread pai n at follow-up. Although depressive symptoms and sleep problems were associ ated with the change of neck pain to widespread pain, neither they nor othe r measured factors showed independent explanatory power in multiple logisti c regression analysis. In conclusion, fluctuation of pain symptoms occurred mainly among pain cohorts. Depressive and sleep problems may have an effec t on the spreading of regional neck pain to widespread pain. Pain threshold measurement and evaluation of depressive and sleep problems may be useful tools for secondary prevention of musculoskeletal pain in pre-adolescents.