Association Between Widespread Pain Scores and Functional Impairment and Health-Related Quality of Life in Clinical Samples of Children

• Higher widespread pain scores were associated with poorer health-related quality of life in children.
• Widespreadedness of pain had greater associations with health-related quality of life than pain intensity.
• Higher widespread pain scores were associated with greater functional impairment.
• Specifically, widespread pain was associated with impairment with routine activities.
• Findings support routine evaluation of widespread pain in pediatric pain assessment.

Pain involving several body regions generally represents nervous system pathophysiology shifting from predominantly peripheral to more central. In adults, higher widespread pain scores are clinically meaningful and confer risk for poor response to treatment. It is unknown whether widespread pain is similarly important in children. To address this gap, we conducted an observational study examining 1) associations between widespread pain and functional impairment and health-related quality of life (HRQOL) in clinical pediatric samples, and 2) associations among sociodemographic factors and pain catastrophizing with widespread pain scores. Participants were 166 children aged 10 to 18 years from 3 samples (acute pain, presurgery, chronic pain). Children self-reported pain intensity, pain catastrophizing, functional impairment, and HRQOL. Children indicated pain locations on a body diagram, which was coded using the American College of Rheumatology definition of widespread pain. Results revealed higher widespread pain scores were associated with greater functional impairment with routine activities (F = 3.15, P = .02) and poorer HRQOL (F = 3.29, P = .02), adjusting for pain intensity, study group, and demographic characteristics. Older age (B = .11, P = .02), and Hispanic ethnicity (B = .67, P = .04) were associated with higher widespread pain scores. Findings support incorporating evaluation of widespread pain into pediatric pain assessment. Future research is needed to examine the longitudinal effect of widespread pain on children's treatment outcomes.PerspectiveThis article examines the association between widespread pain scores and functional impairment and HRQOL in community and clinical samples of children. Assessment of the spatial distribution of the pain experience provides unique information that may identify children at risk for poorer health.