Pain in Youths With Neuromuscular Disease

To examine the prevalence and characteristics of pain in children with neuromuscular disease (NMD), 42 youths with NMD underwent a comprehensive evaluation including a detailed intake interview and structured questionnaire that included demographic and functional data. Youths who reported chronic pain were further queried about pain characteristics, locations, and intensity using an 11-point numerical rating scale and a modified Brief Pain Inventory (BPI). The sample consisted of 24 males (57%) and 18 females (43%), ages ranging from 9 to 20 years (M = 14.8, SD = 2.96). Participants included 14 (37%) with Duchenne muscular dystrophy, 6 (14%) with myotonic dystrophy, 2 (5%) with Becker dystrophy, 2 (5%) with limb-girdle dystrophy, 2 (5%) with congenital muscular dystrophy, 1 (2%) facioscapulohumeral, and 15 (36%) were classified as ‘‘other NMD.’’ Twenty-one (50%) were ambulatory; 26 (62%) used power wheelchairs/scooters, 9 (2%) used manual wheelchairs, 3 (.07%) used crutches/canes, and 1 (2%) used a walker. A total of 23 (55%) of the youths reported having chronic pain. Current pain intensity was 1.30 (range = 0-6), mean pain intensity over the past week was 2.39 (range = 0-7), mean pain duration was 8.75 hours (SD = 12.84). Pain in the legs was most commonly reported and 83% reported using pain medications. This study indicates that chronic pain is a significant problem in youths with NMD. These data strongly support making comprehensive pain assessment and management an integral part of the standard of care for youths with NMD.

[1]  T. Palermo,et al.  Pain, Fatigue, and Health-related Quality of Life in Children and Adolescents With Chronic Pain , 2009, The Clinical journal of pain.

[2]  A. Stewart,et al.  Body Awareness: Construct and Self-Report Measures , 2009, PloS one.

[3]  K. Raichle,et al.  Impact of Biopsychosocial Factors on Chronic Pain in Persons With Myotonic and Facioscapulohumeral Muscular Dystrophy , 2009, The American journal of hospice & palliative care.

[4]  K. Raichle,et al.  Psychosocial factors and adjustment to chronic pain in spinal cord injury: replication and cross-validation. , 2009, Journal of rehabilitation research and development.

[5]  I. Molton,et al.  Coping With Chronic Pain Among Younger, Middle-Aged, and Older Adults Living With Neurological Injury and Disease , 2008, Journal of aging and health.

[6]  R. Abresch,et al.  Pain in myotonic muscular dystrophy, type 1. , 2008, Archives of physical medicine and rehabilitation.

[7]  R. Abresch,et al.  Pain in persons with postpolio syndrome: frequency, intensity, and impact. , 2008, Archives of physical medicine and rehabilitation.

[8]  D. Drotar,et al.  Pain and activity limitations in children with Duchenne or Becker muscular dystrophy , 2008, Developmental medicine and child neurology.

[9]  J. Engel,et al.  The Impact of Child Disability Type on the Family , 2008, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[10]  P. Rosenbaum,et al.  Development of the Gross Motor Function Classification System for cerebral palsy , 2008, Developmental medicine and child neurology.

[11]  J. Miró,et al.  The severity of chronic pediatric pain: an epidemiological study. , 2008, The journal of pain : official journal of the American Pain Society.

[12]  G. Shahar,et al.  Patients' self-criticism is a stronger predictor of physician's evaluation of prognosis than pain diagnosis or severity in chronic pain patients. , 2008, The journal of pain : official journal of the American Pain Society.

[13]  R. Abresch,et al.  Chronic pain in persons with myotonic dystrophy and facioscapulohumeral dystrophy. , 2008, Archives of physical medicine and rehabilitation.

[14]  F. Weaver,et al.  Pain among veterans with spinal cord injury. , 2008, Journal of rehabilitation research and development.

[15]  Christopher Morris MSc SROrth,et al.  Gross Motor Function Classification System: impact and utility , 2007 .

[16]  M. Blades,et al.  Brief report: assessing the impact of rating scale type, types of items, and age on the measurement of school-age children's self-reported quality of life. , 2006, Journal of pediatric psychology.

[17]  Jay J. Han,et al.  The Importance of Assessing Quality of Life in Patients with Neuromuscular Disorders , 2007, The American journal of hospice & palliative care.

[18]  M. Jensen,et al.  Coping with chronic pain associated with cerebral palsy. , 2006, Occupational therapy international.

[19]  V. Hinton,et al.  Social Behavior Problems in Boys with Duchenne Muscular Dystrophy , 2006, Journal of developmental and behavioral pediatrics : JDBP.

[20]  A. Thevenon,et al.  Pain and Neuromuscular Disease: The Results of a Survey , 2006, American journal of physical medicine & rehabilitation.

[21]  M. Hanley,et al.  The scope and nature of pain in persons with multiple sclerosis , 2006, Multiple sclerosis.

[22]  Debra L Roter,et al.  Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? , 2006, Patient education and counseling.

[23]  M. Jensen,et al.  Coping with cerebral palsy pain: a preliminary longitudinal study. , 2006, Pain medicine.

[24]  J. Engel,et al.  Exploring chronic pain in youths with Duchenne Muscular Dystrophy: a model for pediatric neuromuscular disease. , 2005, Physical medicine and rehabilitation clinics of North America.

[25]  R. Abresch,et al.  Chronic pain in persons with neuromuscular disease. , 2005, Physical medicine and rehabilitation clinics of North America.

[26]  R. Abresch,et al.  Chronic pain in persons with neuromuscular disease. , 2005, Archives of physical medicine and rehabilitation.

[27]  M. Jensen,et al.  Chronic pain in individuals with spinal cord injury: a survey and longitudinal study , 2005, Spinal Cord.

[28]  T. Bird,et al.  Ventilatory support in facioscapulohumeral muscular dystrophy , 2005, Neurology.

[29]  R. Abresch,et al.  The reliability and validity of a self-report version of the FIM instrument in persons with neuromuscular disease and chronic pain. , 2005, Archives of physical medicine and rehabilitation.

[30]  T. Palermo,et al.  Juvenile idiopathic arthritis: parent-child discrepancy on reports of pain and disability. , 2004, The Journal of rheumatology.

[31]  S. M. van der Maarel,et al.  Ventilatory support in facioscapulohumeral muscular dystrophy , 2004, Neurology.

[32]  D. Drotar,et al.  Development and validation of the Child Activity Limitations Interview: a measure of pain-related functional impairment in school-age children and adolescents , 2004, Pain.

[33]  M. Jensen,et al.  Natural History of Chronic Pain and Pain Treatment in Adults with Cerebral Palsy , 2004, American journal of physical medicine & rehabilitation.

[34]  C. Morris,et al.  Gross Motor Function Classification System: impact and utility , 2004 .

[35]  D. Giles,et al.  Sleep Quality and Presleep Arousal in Chronic Pain , 2000, Journal of Behavioral Medicine.

[36]  M. Jensen,et al.  Validity of pain intensity assessment in persons with cerebral palsy: a comparison of six scales. , 2003, The journal of pain : official journal of the American Pain Society.

[37]  D. Ehde,et al.  Chronic Pain Secondary to Disability: A Review , 2003, The Clinical journal of pain.

[38]  R. Abresch,et al.  Assessment of pain and health-related quality of life in slowly progressive neuromuscular disease , 2002, The American journal of hospice & palliative care.

[39]  R. Abresch,et al.  Health-related quality of life in peripheral neuropathy. , 2001, Physical medicine and rehabilitation clinics of North America.

[40]  J C van der Wouden,et al.  Chronic pain and its impact on quality of life in adolescents and their families. , 2001, Journal of pediatric psychology.

[41]  T. Palermo Impact of Recurrent and Chronic Pain on Child and Family Daily Functioning: A Critical Review of the Literature , 2000, Journal of developmental and behavioral pediatrics : JDBP.

[42]  M. Jensen,et al.  Comparative reliability and validity of chronic pain intensity measures , 1999, PAIN.

[43]  K. Craig,et al.  Biobehavioral responses to acute pain in adolescents with a significant neurologic impairment. , 1999, The Clinical journal of pain.

[44]  T D Bird,et al.  Neuropathic pain in Charcot-Marie-Tooth disease. , 1998, Archives of physical medicine and rehabilitation.

[45]  K. Craig,et al.  Agreement between child and parent reports of pain. , 1998, The Clinical journal of pain.

[46]  F. Keefe,et al.  Pain in young adults--III: Relationships of three pain-coping measures to pain and activity interference. , 1996, The Clinical journal of pain.

[47]  Carter Gt Phrenic nerve involvement in Charcot-Marie-Tooth. , 1995 .

[48]  R. Abresch,et al.  Profiles of neuromuscular diseases. Becker's muscular dystrophy. , 1995, American journal of physical medicine & rehabilitation.

[49]  E. W. Johnson The selling of pain. , 1995, American journal of physical medicine & rehabilitation.

[50]  R. Abresch,et al.  Profiles of neuromuscular diseases. Hereditary motor and sensory neuropathy, types I and II. , 1995, American journal of physical medicine & rehabilitation.

[51]  R. Abresch,et al.  Profiles of neuromuscular diseases. Limb-girdle syndromes. , 1995, American journal of physical medicine & rehabilitation.

[52]  R. Abresch,et al.  Profiles of neuromuscular diseases. Facioscapulohumeral muscular dystrophy. , 1995, American journal of physical medicine & rehabilitation.

[53]  R. Abresch,et al.  Spinal muscular atrophy , 2010, Journal of the Neurological Sciences.

[54]  R. Abresch,et al.  Becker's muscular dystrophy , 1995 .

[55]  C. Cleeland,et al.  Pain assessment: global use of the Brief Pain Inventory. , 1994, Annals of the Academy of Medicine, Singapore.

[56]  G. Carter,et al.  Evaluation of phrenic nerve and pulmonary function in hereditary motor and sensory neuropathy, type I , 1992, Muscle & nerve.

[57]  Paul Karoly,et al.  Self-report scales and procedures for assessing pain in adults , 1992 .

[58]  T. Strax Psychological issues faced by adolescents and young adults with disabilities. , 1991, Pediatric annals.

[59]  C. Cleeland,et al.  Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases , 1983, Pain.

[60]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.