Grant: Regional Partnership Program Fellowship

Approximately one in 1000 children suffer from Juvenile Idiopathic Arthritis ("Idiopathic" meaning of unknown cause), a condition that can cause an unpredictable course of chronic pain and disability throughout the lifespan of the affected individual. Childhood pain can interfere with participation in school and social activities, cause anxiety and distress and therefore have a negative impact on normal childhood development. Pain from arthritis is rarely constant; it fluctuates during the day. Different types of adult arthritis have distinct symptom patterns. Adults with rheumatoid arthritis typically have more pain in the morning, while those with osteoarthritis usually have more pain in the evening. Patterns of pain are important to understand because they help clinicians and researchers understand possible sources of pain aggravation as well as point to potential treatments. In this study, we intend to look at: (a) how pain varies during the day for children with arthritis (b) whether or not pain patterns are associated with components of the disease, such as the amount of inflammation, by general characteristics of the child, such as age and sex, or psychological characteristics of the child, such as mood, or anxiety and (c) whether pain patterns are influenced by other factors such as physical activity. To our knowledge this will be the first study to look at how pain varies during the day in children with arthritis. This study will help clinicians, patients and their families have a better understanding of the pain experience which will lead to better pain management for children with arthritis. This research will provide a basis for other research to explore how treatment such as medications or physical activity affect the whole day pain experience and what mechanisms drive the changes in pain throughout the day.