Pain trajectories in children and adolescents with cerebral palsy: A longitudinal population‐based register study

Aim To examine longitudinal trajectories of pain occurrence in children with cerebral palsy (CP) aged 1 year to 17 years. Method A longitudinal register‐based study was conducted using data from the Swedish Cerebral Palsy Follow‐up Program (2007–2023). Individuals ( n = 4887) with confirmed CP, a minimum of three pain assessments, and any Gross Motor Function Classification System (GMFCS) levels were included (median age at baseline = 3 years 5 months; interquartile range = 4 years 2 months; males = 2864 [58.6%]; Communication Function Classification System levels I−III = 3158 [64.62%]). Pain reports indicated general pain in the past 4 weeks. Group‐based trajectory modelling was applied. Results Four pain occurrence trajectories were identified: (1) increasing trend, low occurrence (probability of experiencing pain below 0.5 across all ages; 20.28%); (2) increasing trend, high occurrence (30.30%); (3) decreasing trend (26.85%); and (4) consistently high occurrence (22.57%). Compared to trajectory 1, individuals classified in GMFCS levels IV and V at baseline were more likely in trajectory 3 (log odd estimate = 0.56; standard error [SE] = 0.16) and 4 (estimated = 0.57; SE = 0.15), while females were more likely in trajectory 2 (estimated = 0.40; SE = 0.13) and 4 (estimated = 0.43; SE = 0.12). Interpretation Half of the children experienced high pain occurrence trajectories, while the rest showed low pain occurrence or improvement over time.