Toward precision pediatric pain care: integrating mechanistic science, real-world measurement, and patient partnership

Abstract

Pediatric pain science is at an inflection point. Advances in neuroscience, behavioral science, digital health technologies, and patient engagement are rapidly expanding how chronic pain in youth can be understood, measured, and treated. Yet despite these advances, many children and adolescents continue to experience persistent pain-related disability and limited access to effective care, reflecting a gap between scientific discovery and real-world clinical practice. In this perspective, we propose the BRIDGE framework (Biobehavioral Research Integrated with Digital Monitoring and Guided Engagement) as a model for advancing pediatric pain research and care. Mechanistic science is increasingly identifying neural, behavioral, and contextual processes that contribute to pain persistence and recovery, creating opportunities to target modifiable mechanisms underlying pain-related disability. At the same time, digital health technologies including wearable sensors and ecological momentary assessment enable continuous measurement of activity, physiology, and patient-reported experiences in daily life, offering new insights into the dynamic nature of pain and the potential to develop digital biomarkers of risk, recovery, and treatment response. Central to this framework is meaningful partnership with youth and families, ensuring that innovations in measurement and intervention remain aligned with patient priorities and lived experience. Integrating these domains can support precision behavioral interventions, adaptive treatment strategies, and scalable models of care that expand access to evidence-based pediatric pain treatment.