title: Clinical Phenotyping of Youth With New-Onset Musculoskeletal Pain: A Controlled Cohort Study.
abstract: The course of pediatric musculoskeletal pain from acute to chronic has not been well described and there is limited understanding of how to identify individuals with new-onset pain who may be predisposed to developing persisting symptoms. Thus, the purpose of this study was to describe the clinical phonotype of treatment-seeking youth with new-onset musculoskeletal pain compared with youth with and without chronic pain. Further, we tested predictors of pain-related disability and pain sensitivity in the new-onset pain sample.
  
  
  
  Participants were 191 youth, ages 10 to 17 years, representing 3 cohorts (new-onset musculoskeletal pain, chronic musculoskeletal pain, and a comparison group without chronic pain). Participants completed questionnaire measures of pain characteristics, psychological functioning, sleep, and pain-related disability. They also attended a laboratory visit to complete an experimental pain assessment using heat and cold stimuli to assess pain sensitivity and conditioned pain modulation.
  
  
  
  Findings revealed youth with new-onset musculoskeletal pain had a distinct clinical phenotype where symptoms of pain and disability were in the mid-range between those of youth with diagnosed chronic musculoskeletal pain and youth in the community without chronic pain. Linear regressions within the new-onset pain sample demonstrated poorer sleep quality and higher pain fear predicted greater pain-related disability, and pain catastrophizing predicted cold pressor sensitivity.
  
  
  
  Clinical phenotyping of youth with new-onset musculoskeletal pain highlights factors relevant to the pain experience. Future research can examine the roles of these variables in predicting longitudinal risk for chronic pain and disability.
authors.affiliation: *Institute on Development & Disability, Oregon Health & Science University, Portland, OR †Seattle Children's Research Institute ‡Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
authors.forename: Amy
authors.initials: A
authors.lastname: Lewandowski Holley
authors.forename: Anna C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Elise
authors.initials: E
authors.lastname: Cho
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Palermo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement; D010641:Phenotype; D012890:Sleep; D011795:Surveys and Questionnaires