Breadth and visibility of children's lower limb chronic musculoskeletal pain: a scoping review

To identify the types of conditions reported in peer-reviewed literature that result in chronic musculoskeletal lower limb pain in children and adolescents and explore the alignment of these conditions with the chronic pain reporting codes indexed in the International Classification of Diseases 11th Revision (ICD-11). This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched (Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library). Articles involving children and adolescents under 18 years and reporting on chronic musculoskeletal pain of the lower limb were included. We assigned an ICD-11 code to each condition based on details reported in the study. We recorded whether any of the presenting conditions were linked to an ICD-11 chronic pain manifestation code. From 12 343 records, 418 papers were included. There were 124 unique conditions associated with chronic lower limb pain, the most commonly reported being chronic widespread musculoskeletal pain (24 studies) and juvenile idiopathic arthritis (26 studies). Only 11.1% of presenting conditions were linked to an ICD-11 chronic pain manifestation code. Most presenting conditions associated with chronic pain in the lower limb do not have a chronic pain manifestation code in the new global standard for recording health information. This means chronic pain associated with common lower limb conditions may remain invisible in global statistics.