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      Musculoskeletal pain and its effect on daily activity and behaviour in Icelandic children and youths with juvenile idiopathic arthritis: a cross-sectional case-control study

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          Abstract

          Background

          Juvenile idiopathic arthritis is characterised by recurring episodes of acute inflammation, with joint swelling in one or more joints, often accompanied by pain. These episodes can now be controlled better than in the past because of a new category of medications. However, despite more stable disease activity, pain may continue to cause problems in the children with juvenile idiopathic arthritis and can reduce their performance of routine physical activities and participation in social or school activities.

          Aim

          To evaluate the prevalence of pain, pain intensity, pain behaviour, and pain interference in Icelandic children with juvenile idiopathic arthritis compared with healthy peers.

          Methods

          A cross-sectional, case-control study including 8-18 years old children; 28 with juvenile idiopathic arthritis and 36 in a control group. The children answered questions on pain experienced during the last 7 days, painful areas of the body and pain frequency. They completed short form versions of the Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires on pain intensity, pain behaviour, and pain interference.

          Results

          Significantly more children with juvenile idiopathic arthritis had pain compared with the control group ( p = 0.02). Children with JIA also had a greater number of painful body areas ( p = 0.03), more pain intensity ( p = 0.009), and showed more pain behaviour ( p = 0.006), and pain interference ( p = 0.002). Children with juvenile idiopathic arthritis who had pain, experienced more pain interference ( p = 0.023) than their peers who had pain. However, the groups did not differ in terms of pain intensity ( p = 0.102) and pain behaviour ( p = 0.058).

          Conclusion

          The research results indicate that pain experience was different between children with juvenile idiopathic arthritis and the control group. The results suggest that further research of the role of pain management on functional outcomes in children with juvenile idiopathic arthritis is needed.

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          Most cited references28

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          International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001.

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            Juvenile idiopathic arthritis.

            Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and symptoms, and, in some cases, genetic background. The cause of disease is still poorly understood but seems to be related to both genetic and environmental factors, which result in the heterogeneity of the illness. Although none of the available drugs has a curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of drugs such as anticytokine agents, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents. Further insights into the disease pathogenesis and treatment will be provided by the continuous advances in understanding of the mechanisms connected to the immune response and inflammatory process, and by the development of new drugs that are able to inhibit selectively single molecules or pathways.
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              The epidemiology of chronic pain in children and adolescents revisited: a systematic review.

              Chronic and recurrent pain not associated with a disease is very common in childhood and adolescence, but studies of pain prevalence have yielded inconsistent findings. This systematic review examined studies of chronic and recurrent pain prevalence to provide updated aggregated prevalence rates. The review also examined correlates of chronic and recurrent pain such as age, sex, and psychosocial functioning. Studies of pain prevalence rates in children and adolescents published in English or French between 1991 and 2009 were identified using EMBASE, Medline, CINAHL, and PsycINFO databases. Of 185 published papers yielded by the search, 58 met inclusion criteria and were reviewed, and 41 were included in the review. Two independent reviewers screened papers for inclusion, extracted data, and assessed the quality of studies. Prevalence rates ranged substantially, and were as follows: headache: 8-83%; abdominal pain: 4-53%; back pain: 14-24%; musculoskeletal pain: 4-40%; multiple pains: 4-49%; other pains: 5-88%. Pain prevalence rates were generally higher in girls and increased with age for most pain types. Lower socioeconomic status was associated with higher pain prevalence especially for headache. Most studies did not meet quality criteria. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                thbjorg@hi.is
                Journal
                Pediatr Rheumatol Online J
                Pediatr Rheumatol Online J
                Pediatric Rheumatology Online Journal
                BioMed Central (London )
                1546-0096
                15 July 2022
                15 July 2022
                2022
                : 20
                : 48
                Affiliations
                [1 ]GRID grid.14013.37, ISNI 0000 0004 0640 0021, Department of Physical Therapy, School of Health Sciences, , University of Iceland, ; Reykjavik, Iceland
                [2 ]GRID grid.410540.4, ISNI 0000 0000 9894 0842, Children’s Medical Center, University Hospital of Iceland, ; Reykjavik, Iceland
                Author information
                http://orcid.org/0000-0003-4566-9333
                Article
                706
                10.1186/s12969-022-00706-6
                9287931
                35841034
                7b43db74-b1a3-4b10-b40a-b8d6e84c0105
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 March 2022
                : 26 June 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004103, Landspítali Háskólasjúkrahús;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2022

                Pediatrics
                children,juvenile idiopathic arthritis (jia),musculoskeletal pain
                Pediatrics
                children, juvenile idiopathic arthritis (jia), musculoskeletal pain

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