Musculoskeletal pain in children: risk linked with family history of pain

By Nicole MacKee
Children with a family history of musculoskeletal pain may be at greater risk of developing musculoskeletal pain themselves, Australian researchers have reported in Pain.

Their systematic review and meta-analysis included six longitudinal studies and 23 cross-sectional studies. In the longitudinal studies, which included more than 42,000 participants, they found that children and adolescents with a family history of musculoskeletal pain had 58% higher odds of also experiencing musculoskeletal pain.

The findings from 18 cross-sectional studies with more 17,000 participants were consistent with the longitudinal study results.

Subgroup analyses showed greater odds of musculoskeletal pain in children whose mother (53% increased odds), father (59%) or sibling (99%) reported a history of pain. And the odds of a child experiencing musculoskeletal pain were further increased when both parents reported pain.

Research coauthor Associate Professor Steven Kamper, Principal Research Fellow at the University of Sydney’s School of Public Health, said it was striking to find such consistency across the studies.

‘That really gives us a measure of confidence that there is something pretty robust here,’ Associate Professor Kamper told Medicine Today.

Although the mechanism of the association remained unclear, Associate Professor Kamper said it was likely that both genetic and environmental influences were at play.

‘The world of understanding pain has very much moved to viewing pain in a biopsychosocial context,’ he said. ‘There is much more to people’s experience of pain than some sort of damage to their tissues, there are all sorts of influences, including fear, depression and anxiety. So, hypothesising that this pain may be something to do with the culture of the family makes sense.’

Associate Professor Kamper said there was still much to learn about the genetics of pain. ‘It may be a psychological or physical genetic predisposition,’ he said. ‘We think both are important but there is also this socialisation aspect as well.’

He said international researchers were evaluating a possible role for family interventions in managing pain in children and adolescents with chronic or high impact pain (Eur J Pain 2017; 21: 1571-1581).

‘There is a subset of children, particularly adolescents, with chronic pain conditions who have a huge impact on their life. They stop going to school, there is psychological dysfunction and researchers are now looking at family treatment programs for these children,’ he said.
Pain 2019; 160: 2430-2439.