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. 2025 Jul;67(7):854-874.
doi: 10.1111/dmcn.16254. Epub 2025 Feb 12.

Pain in adults with cerebral palsy: A systematic review

Jennifer M Ryan  1 , Jessica Burke  1 , Rachel Byrne  2 , Emily Capellari  3 , Adrienne Harvey  4 , Neil E O'Connell  5 , Donna Omichinski  3 , Elisabet Rodby-Bousquet  6   7 , Mark Peterson  3 ; Adult CP Clinical Practice Guideline Working Group
Collaborators, Affiliations

Pain in adults with cerebral palsy: A systematic review

Jennifer M Ryan et al. Dev Med Child Neurol. 2025 Jul.

Abstract

Aim: To describe the prevalence and incidence of pain, identify prognostic factors for pain, determine psychometric properties of tools to assess pain, and evaluate effectiveness of interventions for reducing pain among adults with cerebral palsy (CP).

Method: Six databases were searched to identify studies published since 1990 in any language that met eligibility criteria defined for each objective. Titles, abstracts, and full texts were screened by two independent reviewers.

Results: Sixty-three studies were identified; 47 reporting prevalence, 28 reporting prognostic factors, four reporting psychometric properties, five evaluating intervention effectiveness. Pain prevalence ranged from 24% to 89%. Prevalence was higher among adults with CP than in adults without it. Communication function, sex, and age were prognostic factors for pain prevalence. Numerical, verbal, and pictorial rating scales were valid for assessing pain intensity in adults with CP. Pharmacological and surgical interventions had no effect on pain. An active lifestyle and sports intervention reduced pain in adults with CP compared with usual care.

Interpretation: Many adults with CP experience pain, although prevalence estimates vary considerably. The quality of evidence for prognostic factors and interventions is very low to low. There is a lack of evidence about effective pain management among adults with CP.

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Conflict of interest statement

The authors have stated that they had no interests that might be perceived as posing a conflict or bias.

Figures

FIGURE 1
FIGURE 1
Prevalence of pain reported in each study.
See this image and copyright information in PMC

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