Treatment of Chronic Musculoskeletal Pain in Youth

April 6, 2021   |   Evidence in Integrative Healthcare

Chronic musculoskeletal pain conditions are common in adults but according to a newly published study in the Journal of Pediatrics and highlighted by the National Center for Complementary and Integrative Health (NCCIH), chronic musculoskeletal pain conditions seem to be frequent among children and youth also. Using the National Ambulatory Medical Care Survey (NAMCS) data from 2007-2015, researchers from the NCCIH and Universite de Montreal identified that while little evidence exists for the effectiveness of medications for treating these conditions in children and adolescents, medications appear to be the main treatment prescribed. There were a number of findings from this study, with a few highlights as follows:

• Non-pharmacologic treatments like physical therapy and complementary therapies occurred less often than pharmacologic treatments, “…going against the evidence on the effectiveness of certain nonpharmacologic treatments.” (italics ours)
• The most frequently prescribed treatment was non-opioid medications with two of the most frequent being nonsteroidal anti-inflammatories and antidepressants.
• Opioid prescriptions:
  • Were rare for children and adolescents
  • Occurred in 23% of visits among young adults
  • Were more likely for patients who paid out-of-pocket
  • Were less likely to be prescribed by pediatricians than other providers

As captured in the NCCIH article, “The researchers noted that finding ways to increase health care providers’ use of evidence-based nonpharmacologic approaches is an important next step for treating chronic pain in youth.”