Pain medication use for musculoskeletal pain among children and adolescents: a systematic review

Al-Janabi, Nabil; Olesen, Anne Estrup; Straszek, Christian Lund; Guldhammer, Clara; Rathleff, Michael Skovdal; Andreucci, Alessandro

doi:10.1515/sjpain-2021-0033

Cited by 15 publications

(7 citation statements)

References 77 publications

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“…Conversely, one participant felt that the GP acknowledged her knee pain, despite advising 'wait and see' and associated this to the GP's young age. In contrast with recent findings [34,35], only 1 out of 8 participants self-managed knee pain with pain medication. Future studies might explore whether receiving the wait-and-see recommendation has a direct impact on the use of pain medication, their future ability to self-manage their knee pain between consultations and future care seeking behaviors [36].…”

Section: Comparison With Previous Studiescontrasting

confidence: 99%

“I had already tried that before going to the doctor” – exploring adolescents’ with knee pain perspectives on ‘wait and see’ as a management strategy in primary care; a study with brief semi-structured qualitative interviews

Andreucci

Rathleff

Reuther

et al. 2022

Scandinavian Journal of Pain

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Objectives The aim of this study was to examine how the “wait-and-see” recommendation affects adolescents’ understanding of their illness and symptoms and their care-seeking behavior. Methods This study included brief qualitative, semi-structured online interviews. Adolescents (age 10–19 years) with long-term knee pain, who had been recommended “wait-and-see” by their general practitioner (GP), were recruited via previous studies and social media. Two researchers conducted brief semi-structured interviews through Microsoft Teams. An interview guide with open questions was created prior to the interviews and updated as new questions emerged. The extracted data was transcribed and analyzed via a reflexive thematic approach in NVivo. Results Eight adolescents (mean age 17.8) with longstanding or recurrent knee pain (mean duration 3.5 years) were included. The analysis identified four main themes: (1) The perception of wait and see over time, (2) The GP’s acknowledgement and consideration, (3) experienced limitation from knee pain and (4) the importance of getting a diagnosis. The perception of “wait-and-see” approach changed from positive to negative when adolescents received the recommendation multiple times. Adolescents experienced frustration with their situation and a lack of consideration from their GP made them cautious about seeking additional care. Knee pain significantly limited the adolescents’ physical-and social activities. Receiving a diagnosis was important and helped adolescents dealing with their pain. Conclusions The connotation of wait-and-see changed from positive to negative for adolescents when receiving the recommendation multiple times. The participants felt getting a clinical diagnosis was a relief. Furthermore, the lack of consideration and acknowledgement from the GP plays an essential role in the adolescent’s understanding of their knee pain. Implications Recommending adolescents to “wait-and-see” multiple times in relation to their knee problems can lead adolescents experience frustration and a lack of consideration from their GP. It would be advisable for GPs to provide adolescents with a diagnosis as it can facilitate them in dealing with their pain and to use simple language when explaining adolescents their condition to improve communication.

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Section: Comparison With Previous Studiescontrasting

confidence: 99%

“I had already tried that before going to the doctor” – exploring adolescents’ with knee pain perspectives on ‘wait and see’ as a management strategy in primary care; a study with brief semi-structured qualitative interviews

Andreucci

Rathleff

Reuther

et al. 2022

Scandinavian Journal of Pain

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“…Prior to seeking care many adolescents used over-the-counter pain medicine as a first step to self-manage their pain although this approach had short lasting or no effect on their pain. Over-the-counter pain medicine was used frequently and for long periods among the sport active adolescents which aligns with the findings in a recent review on the use of over-the-counter pain medicine among adolescents [ 17 ]. With problem solving being one of the 5 core-skills of self-management [ 12 ] our findings indicate that care-seeking adolescents with LBP need alternative strategies when trying to self-management.…”

Section: Discussionsupporting

confidence: 83%

Competences to self-manage low back pain among care-seeking adolescents from general practice - a qualitative study

Straszek,

Skrubbeltrang,

O’Sullivan

et al. 2023

BMC Prim. Care

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Background There is limited knowledge about when and how adolescents with low back pain (LBP) interact with health care providers. This limits our understanding of how to best help these young patients. This study aimed to understand when and how care-seeking adolescents with LBP interact with health care providers and which health literacy competencies and strategies do they use to self-managing their LBP. Method Ten semi-structured interviews (duration 20–40 min) were conducted online among adolescents aged 15–18 with current or recent LBP (pain duration range; 9 months – 5 years). The interview guide was informed by literature on health literacy and self-management in patients. We conducted a semantic and latent thematic data analyses. Results Three major themes emerged from the analysis: (1) Self-management, (2) Pain and Function, and (3) Communication. All adolescents were functionally limited by their pain but the main reason to consult a health care provider was an increase in pain intensity. Many were able to navigate the healthcare system, but experienced difficulties in communicating with health care providers, and many felt that they were not being taken seriously. Their first line self-management option was often over-the-counter pain medicine with limited effects. Most adolescents expressed a desire to self-manage their LBP but needed more guidance from health care providers. Conclusion Adolescents with LBP seek care when pain intensifies, but they lack self-management strategies. Many adolescents want to self-manage their LBP with guidance from health care providers, but insufficient communication is a barrier for collaboration on self-management.

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“…The questions are based on an instrument developed to assess musculoskeletal pain in adolescents 34. We counted all sites from which participants reported weekly or more frequent pain, in compliance with measures of chronic multisite musculoskeletal pain in adolescents from other studies 3 35 36. For regression analysis, we grouped responders based on number of pain sites: 0, 1, 2 and 3 or more sites.…”

Section: Methodsmentioning

confidence: 99%

“…Over-the-counter analgesics (OTCA) are commonly used among adolescents, [1][2][3][4] and use appears to have increased over the past decades. 1 In studies on adolescents, it is consistently found that girls use more pain medication than boys, and that analgesic use increases from early to late adolescence.…”

Section: Introductionmentioning

confidence: 99%

Exposure to traumatic events and use of over-the-counter analgesics in adolescents: cross-sectional findings from the Young-HUNT study

et al. 2023

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ObjectiveFrequent and increasing use of over-the-counter analgesics (OTCA) among adolescents is a public health concern. Prior research indicates that adolescents exposed to traumatic events may be at increased risk of suffering from headaches and musculoskeletal pain. In this study, we assessed the association between trauma exposure and use of OTCA for headaches and musculoskeletal pain.DesignA cross-sectional population study among adolescents, self-reported data on trauma exposure, pain and use of OTCA.Setting and participantsAll 10 608 adolescents aged 13–19 years in a region of Norway were invited in this school-based survey, participation rate was 76%.Outcome measureFrequency of OTCA use for headache and musculoskeletal pain served as separate outcomes in ordinal logistic regression analyses.ResultsTrauma exposure was significantly and consistently related to higher frequency use of OTCA for headache and musculoskeletal pain, of which associations for bullying (OR 1.79, 95% CI 1.50 to 2.12, and OR 2.12, 95% CI 1.70 to 2.66), physical violence (OR 1.49, 95% CI 1.25 to 1.78 and OR 1.83, 95% CI 1.45 to 2.32) and sexual abuse (OR 1.83, 95% CI 1.55 to 2.18 and OR 1.53, 95% CI 1.18 to 1.90) were particularly strong. A dose–response relationship was found between interpersonal violence and OTCA use for headache (OR 1.46, 95% CI 1.29 to 1.66 for one type and OR 1.81, 95% CI 1.53 to 2.14 for two or more types) and musculoskeletal pain (OR 1.61, 95% CI 1.91 to 3.00 for one type and OR 2.39, 95% CI 1.91 to 3.00 for two or more types). The associations remained significant after adjustment for pain, although an attenuation in strength was observed.ConclusionTrauma exposed adolescents use OTCA for headaches and musculoskeletal pain more frequently than those not exposed. The higher frequency of pain conditions among trauma exposed only partially explained their more frequent OTCA use, indicating an increased risk relating to features beyond frequency of pain.

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Pain medication use for musculoskeletal pain among children and adolescents: a systematic review

Cited by 15 publications

References 77 publications

“I had already tried that before going to the doctor” – exploring adolescents’ with knee pain perspectives on ‘wait and see’ as a management strategy in primary care; a study with brief semi-structured qualitative interviews

“I had already tried that before going to the doctor” – exploring adolescents’ with knee pain perspectives on ‘wait and see’ as a management strategy in primary care; a study with brief semi-structured qualitative interviews

Competences to self-manage low back pain among care-seeking adolescents from general practice - a qualitative study

Exposure to traumatic events and use of over-the-counter analgesics in adolescents: cross-sectional findings from the Young-HUNT study

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