Family History of Pain and Risk of Musculoskeletal Pain in Children and Adolescents: A Systematic Review with Meta-Analysis

Background: Little is known about risk factors for musculoskeletal (MSK) pain in children and adolescents. Emerging research has suggested that family factors influence the pain experience of children. This review was undertaken with the main aim of investigating if children and adolescents with a family history of pain are more likely to develop MSK pain. Methods: Systematic review and meta-analysis of longitudinal and cross-sectional observational studies (PROSPERO-CRD42018090130). We considered all records from the inception to February 2018. Included studies reported associations between family history of pain and non-specific MSK pain in children (age<19 years). Outcome of interest were MSK pain. We assessed the methodological quality of studies and the quality of evidence, using the GRADE, for the main analyses. Results: After screening of 6872 titles; six longitudinal and 22 cross-sectional studies were included. Moderate quality evidence from five longitudinal studies (n=42131) showed that children with family history of MSK pain had 58% increased odds of experiencing MSK pain themselves (OR 1.58, 95% CI 1.20 to 2.09). Moderate evidence from 17 cross-sectional studies (n=47747) supported this finding (OR 1.98, 95% 1.65 to 2.38). Subgroup analyses showed that children with maternal, paternal, or sibling history of pain have greater odds of experiencing MSK pain themselves. The odds increased when both parents reported pain [one parent (mother or father) OR=1.6; both parents OR=2.0]. Interpretation: Children with a family history of pain are at higher risk of experiencing MSK pain. Understanding the mechanism by which this occurs would inform prevention and treatment efforts. Funding: None. Declaration of Interest: None.