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Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations.

ABSTRACT: BACKGROUND:The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA). METHODS:Forty-five patients with JIA (median age 12?years) and 16 healthy matched controls (median age 13?years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophizing, pain locations and jaw function). RESULTS:JIA patients with orofacial pain had higher degree of stress, depression, catastrophizing and jaw dysfunction compared to subjects without. In turn, these factors were associated with orofacial pain intensity. Also, patients with orofacial pain had higher systemic inflammatory activity. CONCLUSIONS:Orofacial pain in patients with JIA is associated with stress, psychological distress, jaw dysfunction and loss of daily living activities. Pain intensity seems to be the major pain aspect related to these factors. In addition, systemic inflammatory activity appears to be an important factor contributing to orofacial pain in JIA.

SUBMITTER: Dimitrijevic Carlsson A

PROVIDER: S-EPMC6921529 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations.

Dimitrijevic Carlsson Alexandra A Wahlund Kerstin K Kindgren Erik E Skogh Thomas T Starkhammar Johansson Carin C Alstergren Per P

Pediatric rheumatology online journal 20191219 1

<h4>Background</h4>The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA).<h4>Methods</h4>Forty-five patients with JIA (median age 12 years) and 16 healthy matched controls (median age 13 years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial facto ...[more]

PMID: 31856854

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Project description:BackgroundJuvenile Idiopathic Arthritis (JIA) is the most common cause of non-infectious joint inflammation in children. Synovial inflammation results in pain, swelling and stiffness. Animal and adult human studies indicate that localized joint-associated inflammation may produce generalized changes in pain sensitivity. The aim was to characterize pain sensitivity in children with JIA to mechanical and thermal stimulus modalities using quantitative sensory testing (QST) at an affected inflamed joint, and compare to children in clinical remission. Generalized hypersensitivity was evaluated by comparing QST measures at the thenar eminence between JIA and healthy control children.Methods60 children aged 7-17 years with JIA participated. QST assessed sensory detection threshold and pain threshold at two sites: (1) affected joint (clinically active or inactive), (2) contralateral thenar eminence. Joint site included finger, wrist, knee and ankle. Clinical status was measured using objective and subjective markers of disease severity. Questionnaires assessed pain intensity and frequency, functional disability, anxiety, pain catastrophization and fatigue. QST data collected from joints were compared within JIA patients: active vs. inactive inflammation; and data from the contralateral thenar eminence were compared between JIA and healthy control cohorts in Europe [EU, (n?=?151)] and the US (n?=?92). Statistical analyses were performed using Kruskal-Wallis with Dunn's post-hoc comparison, Mann-Whitney or Fisher's exact test, where appropriate.ResultsOverall, children with JIA reported low pain scores and low degrees of functional disability. Sensory detection thresholds and pain thresholds were similar in "active" compared to "inactive" joints. Despite this, children with JIA had generalized hypersensitivity at the thenar eminence when compared to healthy children for pressure (vs. EU p?<?0.001), light touch (vs. EU p?<?0.001), cold (vs EU, p?<?0.01; vs US, p?<?0.001) and heat pain (vs EU, p?<?0.05; vs US p?<?0.001).ConclusionsJIA is associated with increased sensitivity to painful mechanical and thermal stimuli, even in absence of pain reports, or markers of disease activity. Future research investigating mechanisms underlying pain hypersensitivity in JIA is warranted; this will in turn guide pharmacologic and non-pharmacologic interventions to prevent or reverse these processes.

Dataset Information

Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations.

Publications

Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations.

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