Daily pain and symptoms in children with polyarticular arthritis
Article first published online: 6 MAY 2003
Copyright © 2003 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 48, Issue 5, pages 1390–1397, May 2003
How to Cite
Schanberg, L. E., Anthony, K. K., Gil, K. M. and Maurin, E. C. (2003), Daily pain and symptoms in children with polyarticular arthritis. Arthritis & Rheumatism, 48: 1390–1397. doi: 10.1002/art.10986
- Issue published online: 6 MAY 2003
- Article first published online: 6 MAY 2003
- Manuscript Accepted: 11 FEB 2003
- Manuscript Received: 31 JUL 2002
- Arthritis Foundation Clinical Science
- Office of Research on Women's Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: AR-45238
- Fetzer Institute
To analyze patterns of daily pain, stiffness, and fatigue related to juvenile arthritis; to examine the relationships of demographics, disease severity, and psychological adjustment to daily disease symptoms; and to examine daily disease symptoms as predictors of reduced participation in school and social activity.
For a 2-month period, 41 children with polyarticular juvenile arthritis completed daily diaries that included measures of symptoms and function. Children also underwent an initial evaluation and 4 followup evaluations that included a joint count, laboratory testing, and completion of questionnaires assessing physical and psychosocial functioning.
Children reported having pain an average of 73% of days, with the majority of children (76%) reporting pain on >60% of all days. On average, children described the intensity of their daily pain as being in the mild to moderate range; however, a significant subgroup (31%) reported pain in the severe range. Higher physician global assessment ratings, increased functional disability, and increased anxiety were significantly associated with increased daily pain and other daily symptoms. Multilevel random-effects analyses indicated that increased daily symptoms of pain, stiffness, and fatigue were significant predictors of reduced participation in school and social activities.
Physicians should consider treating pain more aggressively in children with arthritis, in order to preserve function in school and social domains, as well as physical function. Moreover, optimal pain management in children with arthritis should include therapeutic regimens addressing anxiety as well as standard pharmacologic interventions.