Chronic pain in a JIA child

Chronic pain in a JIA child

Sometimes a child with JIA may require a multidisciplinary approach in managing chronic pain. The specialised team will provide you and your child with techniques and skills aimed at limiting the impact of pain on your child’s physical and psychological health and their social and educational development. 20% to 30% of children and teenagers have pain that keeps going for longer than 3 months. This is called chronic pain. The NZ Starship Complex Pain Team sees about 100 to 120 new patients each year with chronic pain.

Chronic pain in a JIA child

What causes chronic pain?

Pain is part of the body’s alarm system. When it happens following an injury or as part of an illness, the pain will usually go away as the body heals. When pain keeps going for a long time, it doesn’t mean the area is still being damaged. In fact, doctors often can’t find any reason for why the area is still sore. So why does it keep hurting? When pain has been there for a while, our body can get better and better at sending a warning (alarm bells) to the brain. This confuses our brain (like a false alarm) and it keeps telling us we have pain. This can mean just a touch to the skin, or a change in temperature can cause pain from a “false alarm”, so things that didn’t feel sore before, now do and things that only hurt a little bit now HURT A LOT! Chronic pain does not respond to the same treatments as acute pain (like rest and the usual pain medicines).

As pain becomes chronic, changes occur in the nervous system, including in the brain. New pathways are formed and chemicals involved in pain signalling increase. This means that pain can continue to be experienced even after the initial trigger has gone. These changes need not be permanent. The process can be reversed and the pain can improve by learning pain management strategies and accessing agencies that will provide support.

What will happen to my child?

Chronic pain may sometimes be associated with changes in temperature, colour, sweating and sensitivity of the skin, but not always. Pain is an unpleasant experience and therefore frequently results in feelings of sadness, anger, irritability and frustration. Chronic pain can stop a young person doing the things they enjoy. When the young person stops doing those enjoyable activities, their mood can get worse, and in turn so can the pain. This can be a vicious cycle.

Chronic pain in a JIA child_What will happen to my child_Kids With Arthritis

What can be done to help my child?

Helping young people with chronic pain requires multidisciplinary care. A team of health care professionals may be involved in their care and in working with their school.  

 These may include:

  • Family doctor
  • Rheumatologist
  • Pain specialist doctor
  • Physiotherapist/exercise physiologist/osteopath
  • Occupational therapist
  • Psychologist/counsellor/psychiatrist
  • Specialty nurse
  • Music and art therapist

The team may help your child in some of the following areas:

  • Physical Management
    • Graded activity including exercise and stretches
    • Relaxation therapy
  • Mood and sleep
    • Good quality sleep
    • Healthy thinking habits
    • Socializing with friends and loved ones
  • Medicines
    • A number of medications may have a role under the supervision of a specialized team
Chronic pain in a JIA child_What Will Happen In The Future_Kids With Arthritis

What will happen in the future?

For some young people, chronic pain will disappear with time. For others, it may last a very long time or re-occur from time to time. There will be no damage to the body and the body will continue to work normally. Understanding the chronic pain condition, what causes it to flare up for an individual, and how to manage those flares, will enable the young person to lead a full life.