Assessment and Management of Pain in Juvenile Idiopathic Arthritis

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• 作者：Jennifer E. Weiss (1)
  Nadia J. C. Luca (2)
  Alexis Boneparth (3) (6)
  Jennifer Stinson (4) (5)
  
• 刊名：Pediatric Drugs
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：16
• 期：6
• 页码：473-481
• 全文大小：263 KB
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• 作者单位：Jennifer E. Weiss (1)
  Nadia J. C. Luca (2)
  Alexis Boneparth (3) (6)
  Jennifer Stinson (4) (5)
  
  1. Department of Pediatrics, Section of Rheumatology, Joseph M. Sanzari Children鈥檚 Hospital, Hackensack University Medical Center, Hackensack, NJ, 07640, USA
  2. Department of Paediatrics, Section of Rheumatology, University of Calgary and Alberta Children鈥檚 Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada
  3. Department of Pediatrics, Division of Pediatric Rheumatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA
  6. Division of Pediatric Rheumatology, Child Health Institute of New Jersey, 89 French Street Room 1348, First Floor, New Brunswick, NJ, 08901, USA
  4. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
  5. The Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
  
• ISSN：1179-2019

文摘

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.