Acute Pain in Children with Chronic Musculoskeletal Pain: A Comparison of Intensive Interdisciplinary Pain Treatment Versus Control Group

Objectives: Chronic pain corresponds to hypersensitivity to painful stimuli however its relation to acute pain sensitivity in children is poorly understood. We aimed to explore this relationship by comparing acute and chronic pain measures, along with related factors, in children with chronic pain syndromes versus controls, before and after therapeutic intervention. Methods: This study involved 57 children with chronic pain undergoing intensive interdisciplinary pain treatment (IIPT) in a hospital-based pain rehabilitation program and 50 controls. Participants, aged 7-18, were tested using a cold-pressor task (CPT) at admission, discharge, and at first follow-up visit. Data on sleep, anxiety, psychological distress, functional impairment, and pain were collected. Results: Significant differences were found between control and treatment groups in average pain threshold (p < 0.001), pain tolerance (p >0.05), sleep visual analog scale (VAS) (p < 0.001), FDI scores (p < 0.001), PROMIS scores (p < 0.001), GAD scores (p < 0.001), and total BSI scores (p < 0.001) at admission with children with chronic pain scoring worse on all measures save the Pain VAS during the CPT. After treatment and at follow-up, function and mental health measures improved but not acute pain threshold. Discussion: At treatment completion, function and mental health significantly improved but acute pain threshold was unchanged. Post-treatment, sleep quality improved. These findings suggest that while chronic pain treatment improves overall function and mental health, acute pain thresholds may not be a suitable indicator for evaluating the efficacy of chronic pain interventions.