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Assessment and Management of Pain in Juvenile Idiopathic Arthritis

  • Therapy in Practice
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Abstract

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Persistent pain is the most common and distressing symptom of JIA, and pain in childhood arthritis is multifactorial. Children and adolescents with persistent pain due to JIA experience significantly more problems with physical, emotional, social, and school functioning than healthy individuals. Assessment of pain at each office visit is the cornerstone of effective pain management and should include an evaluation of pain intensity, interference, and coping. Following the biopsychosocial model of pain management, a multi-modal approach is recommended for pain control in children with arthritis. Pharmacologic strategies for the treatment of pain in JIA include aggressive treatment of the underlying disease as well as the use of acetaminophen and systemic and topical non-steroidal anti-inflammatory drugs for persistent mild pain. Opioids can be considered in the case of moderate to severe persistent pain. Physical therapies and psychological interventions such as cognitive behavioral therapy are also key components of pain management in JIA.

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Acknowledgments

The authors would like to thank Cynthia Nguyen for her assistance with manuscript organization. J. E. Weiss, A. Boneparth, N. J. C. Luca and J. Stinson declare no conflicts of interest. No funding was received to support the writing of this manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Section of Rheumatology, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ, 07640, USA

    Jennifer E. Weiss

  2. Department of Paediatrics, Section of Rheumatology, University of Calgary and Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada

    Nadia J. C. Luca

  3. Department of Pediatrics, Division of Pediatric Rheumatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA

    Alexis Boneparth

  4. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada

    Jennifer Stinson

  5. The Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    Jennifer Stinson

  6. Division of Pediatric Rheumatology, Child Health Institute of New Jersey, 89 French Street Room 1348, First Floor, New Brunswick, NJ, 08901, USA

    Alexis Boneparth

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  1. Jennifer E. Weiss
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  2. Nadia J. C. Luca
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Correspondence to Alexis Boneparth.

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Weiss, J.E., Luca, N.J.C., Boneparth, A. et al. Assessment and Management of Pain in Juvenile Idiopathic Arthritis. Pediatr Drugs 16, 473–481 (2014). https://doi.org/10.1007/s40272-014-0094-0

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