Chronic Pain in Schoolchildren and its Association With Psychological Wellbeing Before and During the COVID-19 Pandemic

J Adolesc Health. 2021 Nov;69(5):721-728. doi: 10.1016/j.jadohealth.2021.07.027. Epub 2021 Sep 11.


Purpose: The current longitudinal observational study aimed to explore how chronic pain among schoolchildren changed before and during the COVID-19 pandemic, and how changes in chronic pain were related to changes in psychological wellbeing and COVID-19-related experiences.

Methods: Data were collected from N = 777 German schoolchildren (aged 9-17 years) at two assessments before and one assessment during the COVID-19 pandemic lockdown. Participants self-reported chronic pain experience, anxiety, depression, and quality of life across all assessments; and COVID-19-related experiences at the last assessment. Trajectories of anxiety, depression, and quality of life as well as COVID-19-related experiences were analyzed separately for groups of stable chronic pain trajectories compared to chronic pain trajectories that changed during the pandemic.

Results: Chronic pain prevalence was lowest at the assessment during the COVID-19 pandemic (22.8% vs. 29.2% and 29.9% before the pandemic). However, 4.6% experienced new chronic pain onset during the COVID-19 pandemic. This was preceded by heightened depression and anxiety, as well as lowered quality of life scores. These students were also more likely to describe time with their family during the COVID-19 pandemic as tense compared to students who did not develop chronic pain. During the COVID-19 pandemic boys were more likely to recover from ongoing chronic pain than girls.

Conclusions: Overall, during the COVID-19 pandemic the prevalence of chronic pain decreased. However, stressful situations and pre-existing vulnerabilities in psychological wellbeing can facilitate the development of chronic pain during the pandemic.

Keywords: Adolescents; Anxiety; COVID-19; Children; Chronic pain; Depression; Longitudinal study; Quality of life; School-age population.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / epidemiology
  • COVID-19*
  • Child
  • Chronic Pain* / epidemiology
  • Communicable Disease Control
  • Depression / epidemiology
  • Female
  • Humans
  • Male
  • Pandemics
  • Quality of Life
  • SARS-CoV-2