Exploring Resilience in Teens with Chronic Musculoskeletal Pain

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Sabrina Gmuca, MD, MSCE
Children’s Hospital of Philadelphia
Investigator Award 

Up to 40% of children develop chronic musculoskeletal pain at some point during childhood. This is pain that lasts three months or longer and affects the bones, joints and connective tissues. It’s pain that harms everyday activities and is not improved by traditional pain medications. It can be labeled as juvenile fibromyalgia syndrome, chronic widespread pain or amplified musculoskeletal pain. 

For their research project, Sabrina Gmuca, MD, MSCE and her team looked at positive factors affecting these children with chronic pain. Rather than focusing on what was going wrong, researchers were interested in what was helping young people do well.  

They evaluated a coaching program called Promoting Resilience in Stress Management (PRISM) that was developed by researchers at Seattle Children’s Hospital. The one-on-one program can be done on a video call and teaches therapeutic techniques to children living with chronic pain.  

These techniques include mindfulness (being aware of the present moment) and cognitive restructuring (changing the ways one thinks.)  

“Our work was geared towards understanding whether young people with chronic musculoskeletal pain would find this helpful,” says Dr. Gmuca. “Do they like it? Do they actually engage well in resilience coaching?” 

The first study measured resilience, the ability to withstand toughness, in teens with chronic musculoskeletal pain. They found that those with lower resilience levels experienced more pain. They then determined that if they could build one’s resilience, they could improve one’s quality of life.  

This study led to a trial where all participants could take the PRISM program. It revealed that the teens liked PRISM and preferred the program in a video format over an in-person visit. 

“We saw that participants did show improvements in their distress, improvements in their resilience and improvements in their physical function.”