PAIN IN CHILDHOOD RHEUMATIC ARTHRITIS

Pain is a major symptom in chronic inflammatory arthropathies such as rheumatoid arthritis and affects the health status of arthritis patien ts negatively. There has been much debate about the role of pain in ju venile chronic arthritis and this review deals with the controversies about this subject. Pain in children is best understood as a multifact orial concept in which pain is the result of somatosensory, behavioura l and environmental factors. The role of the different factors contrib uting to pain will be assessed with special reference to mechanisms re levant to children with chronic pain, the various instruments to measu re pain, such as visual analogue scales and algometry, and the treatme nt of chronic pain in juvenile chronic arthritis. For a true understan ding of chronic pain in children, these multidimensional assessments s hould be integrated into a biobehavioural model, by means of which a b etter understanding should lead to new therapeutic interventions for o ne of the most common symptoms of rheumatic diseases in childhood: pai n.