Clinical and Economic Long-Term Treatment Outcome of Children and Adolescents with Disabling Chronic Pain
Abstract
Objective: Disabling pediatric chronic pain is accompanied by a significant burden to those affected and by high societal costs. Furthermore, it bears the risk of aggravation into adulthood. Studies have shown intensive interdisciplinary pain treatment to result in short-term positive effects on pain-related and psychological outcomes. In this study, we aimed to prove the stability of the long-term effects of intensive interdisciplinary pain treatment four years after treatment. Methods: This longitudinal observational study followed adolescents who had received intensive interdisciplinary pain treatment over four years. We defined a combined end point, overall improvement (pain intensity, pain-related disability, and school/work absence), and investigated three additional psychological outcome domains (anxiety, depression, pain catastrophizing). We also examined changes to economic parameters (health care utilization, subjective financial burden) and their relationship to patient improvement. Results: Similar patterns were observed for pain-related and psychological outcome domains, with data showing statistically and clinically significant reductions from admission to four-year follow-up. These positive effects were stable from one- to four-year follow-up. Approximately 60% of the adolescents showed an overall long-term improvement. Older age was found to be a risk factor for treatment failure. Economic parameters decreased statistically significantly, particularly for those with an overall improvement of the chronic pain disorder. Conclusions: The results of this study support the long-term effectiveness of intensive interdisciplinary pain treatment and indicate that it can interrupt pain chronification. Future research is warranted to investigate why some of the adolescents did not show improvement and to allow for a more individualized treatment.
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An observational study by Zernikow et al. found that participants had a significant reduction in pain-related and psychological outcome measures, which were sustained at the four-year follow-up.
“The authors found that participants had a significant reduction in pain-related and psychological (anxiety, depression, pain catastrophizing) outcome measures, which were sustained at the four-year follow-up.”
From Psychological interventions for individuals with Ehlers-Danlos syndrome and hypermobility spectrum disorder: a scoping review (2023) · cites this paper as [64]
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- Authors
- Zernikow, B., Ruhe, A.-K., Stahlschmidt, L., Schmidt, P., Staratzke, T., Frosch, M., & Wager, J.
- Affiliations
- Witten/Herdecke University (DE)
- Corresponding author
- Wager, Julia
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-05-09
- Volume
- 19
- Issue
- 1
- Pages
- 16-28
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- OpenAlex
- W2613119585
- Cited by
- 61
- References
- 28
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 11 · 2018: 10 · 2017: 2
- FWCI
- 8.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pediatric chronic pain, adolescents, multidisciplinary pain management, long-term treatment outcomes, pain-related disability, school absenteeism, anxiety, depression, pain catastrophizing, health care utilization, financial burden, pain chronification, treatment failure, age as risk factor
- MeSH terms
- Adolescent, Child, Female, Humans, Longitudinal Studies, Male, Treatment Outcome, Chronic Pain, Pain Management
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