Related Experiment Video
Updated: May 3, 2026
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
Self-reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: an
Maggie H Bromberg1, Mark Connelly, Kelly K Anthony
1University of North Carolina, Chapel Hill.
Insights
Pain, stiffness, and fatigue remain common and disabling symptoms for children with juvenile idiopathic arthritis (JIA), even with advanced treatments. Current therapies need optimization for better symptom management in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Clinical Research
- Symptom Management
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic condition affecting children.
- Contemporary treatments aim to reduce symptoms like pain, stiffness, and fatigue.
- The persistent impact of these symptoms despite aggressive management requires investigation.
Purpose of the Study:
- To assess the prevalence and severity of pain, stiffness, and fatigue in children with JIA.
- To determine if these symptoms remain disabling despite current aggressive treatment strategies.
- To explore the relationship between symptoms, functional limitations, and medication use.
Main Methods:
- Utilized smartphone electronic diaries (e-diaries) for daily symptom tracking in 59 children (ages 8-18) over one month.
- Collected data on pain, stiffness, and fatigue intensity, and functional limitations.
- Analyzed data using descriptive statistics and multilevel modeling, correlating symptoms with function and medication.
Main Results:
- Children reported pain in 66% of e-diary entries; 86% experienced high pain intensity at least once.
- Mean symptom intensity was mild-to-moderate, but disabling moments were frequent.
- Medication class, including disease-modifying antirheumatic drugs and biologics, did not reliably predict symptom intensity.
- Higher pain and stiffness intensity were linked to greater functional limitations.
Conclusions:
- Pain, stiffness, and fatigue are prevalent and disabling in children with JIA, persisting despite advanced treatments like biologics.
- Findings mirror pre-biologic era data, indicating a need for improved JIA symptom management strategies.
- Optimizing pain and symptom control in JIA remains a critical clinical challenge.
Objective:
To use electronic diaries (e-diaries) to determine whether pain, stiffness, and fatigue continue to be common, disabling symptoms in children with juvenile idiopathic arthritis (JIA) despite the use of aggressive treatments in contemporary medical management.
Methods:
Fifty-nine children with JIA (ages 8-18 years) provided ratings of pain, stiffness, and fatigue intensity and functional limitations using a smartphone e-diary 3 times each day for 1 month. Medication information was collected via parent report and checked for accuracy by chart review. Descriptive analyses were conducted to determine typical symptom intensity, frequency, and variability. Multilevel modeling was used to analyze associations between symptoms and functional outcomes and between medication use and symptom intensity.
Results:
Children reported moments of pain in 66% of e-diary entries. No children were entirely pain-free across the reporting period. In 31% of all e-diary entries the visual analog scale score for pain was >40 (high pain intensity), with 86% of children reporting a high level of pain at least once during the study period. The mean ratings of pain, stiffness, and fatigue intensity were in the mild-to-moderate range. Medication class was not a reliable predictor of differences in symptom intensity, even though 79% of children were prescribed a disease-modifying antirheumatic drug and 47% were prescribed a biologic agent. Moments of higher pain intensity and higher stiffness intensity were each uniquely predictive of higher concurrent functional limitations.
Conclusion:
Self-reported pain, stiffness, and fatigue continue to be common in children with JIA, despite contemporary advances in treatment strategies, including use of biologic agents. These findings are surprisingly consistent with previous results from research using daily paper diaries in the pre-biologics era. There remains a pressing and ongoing need to optimize pain and symptom management in JIA.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:21Rheumatic Heart Disease III: Medical Management