Pain in children and adolescents: a common experience

Little is known about the epidemiology of pain in children. We studied the prevalence of pain in Dutch children aged from 0 to 18 years in the open po pulation, and the relationship with age, gender and pain parameters. A rand om sample of 1300 children aged 0-3 years was taken from the register of po pulation in Rotterdam, The Netherlands. In the Rotterdam area, 27 primary s chools and 14 secondary schools were selected to obtain a representative sa mple of 5336 children aged 4-18 years. Depending: on the age of the child, a questionnaire was either mailed to the parents (0-3 years) or distributed at school (4-18 years). Of 6636 children surveyed, 5424 (82%) responded; r esponse rates ranged from 64 to 92%, depending on the subject age and who c ompleted the questionnaire. Of the respondents, 54% had experienced pain wi thin the previous 3 months. Overall, a quarter of the respondents reported chronic pain (recurrent or continuous pain for more than 3 months). The pre valence of chronic pain increased with age, and was significantly higher fo r girls (P < 0.001). In girls, a marked increase occurred in reporting chro nic pain between 12 and 14 years of age. The most common types of pain in c hildren were limb pain, headache and abdominal pain. Half of the respondent s who had experienced pain reported to have multiple pain, and one-third of the chronic pain sufferers experienced frequent and intense pain. These mu ltiple pains and severe pains were more often reported by girls (P < 0.001) . The intensity of pain was higher in the case of chronic pain (P < 0.001) and multiple pains (P < 0.001),;md for chronic pain the intensity was highe r for girls (P < 0.001). These findings indicate that chronic pain is a com mon complaint in childhood and adolescence. In particular, the high prevale nce of severe chronic pain and multiple pain in girls aged 12 years and ove r calls for follow-up investigations documenting the various bio-psycho-soc ial, factors related to this pain. (C) 2000 International Association for t he Study of Pain. Published by Elsevier Science B.V. All rights reserved.