# Tics, Tourette’s and Related Muscle Pain in Children: A Review

## TL;DR

This review explores how tics in children with Tourette Syndrome often lead to musculoskeletal pain, which is commonly overlooked but impacts quality of life.

## Contribution

The paper highlights the under-recognized link between tics and musculoskeletal pain in children, advocating for better therapeutic approaches.

## Key findings

- Musculoskeletal pain is a common but under-recognized comorbidity in children with Tourette Syndrome and tic disorders.
- Pain locations include cervical, throat, shoulder, ocular, and joint areas, often affecting multiple body parts.
- Pharmacological and non-pharmacological interventions are suggested to improve pain management in affected children.

## Abstract

Tourette Syndrome (TS) is a neurodevelopmental disorder depicted by the occurrence of tics and accompanying behavioral problems that commonly appear during childhood. Tics, both motor and vocal, may cause musculoskeletal pain. Both acute and chronic muscle pain have been recognized as a common comorbid aspect of TS-related tic disorders in childhood. The pain most reported in children includes cervical, throat, shoulder, ocular, and joint pain, with most children reporting musculoskeletal pain in more than one part of the body. The impact of muscular pain caused by motor and phonic tics can negatively affect a child’s quality of life. This review describes the association and causation of musculoskeletal pain in childhood tics and TS, which are commonly under recognized and diagnosed. An analysis of the presence of musculoskeletal pain, the severity of the pain, the location of the pain and the movement incapacity due to pain in children is reviewed. Pharmacological and non-pharmacological interventions known to improve musculoskeletal pain in children are highlighted with supportive frameworks evaluated. Further research is needed to better understand musculoskeletal pain cause(s) and prevalence along with age-appropriate assessment methods and outcomes measures. Motor- and phonic-related musculoskeletal pain should be recognized as a common comorbid characteristics of TS and tic disorders in childhood. Such recognition may lead to greater therapeutic opportunities for this problematic condition.