Pain Mechanisms for Juvenile Arthritis
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to understand the pain mechanisms in children with juvenile arthritis, a condition that causes swollen, stiff, and tender joints. Participants will undergo tests to assess their reactions to different temperatures (cold pain tolerance) and pressures (pressure pain thresholds) and will complete questionnaires about their health and lifestyle. The study will also collect samples, such as saliva or blood, to examine immune and hormonal factors. Children aged 9 to 17 with diagnosed or suspected juvenile arthritis, who can complete surveys and follow instructions in English, may be suitable candidates for this trial. As an unphased study, this trial offers a unique opportunity to contribute to scientific understanding and potentially improve future treatments for juvenile arthritis.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.
What prior data suggests that these psychophysical assessments are safe for children with juvenile arthritis?
Previous studies have shown that tests measuring cold pain tolerance cause mild to moderate pain without harming participants. These tests involve placing a hand or forearm in cold water, which gradually becomes more painful. Researchers generally consider them safe and use them to understand pain sensitivity under different conditions.
Research on pressure pain response also confirms the safety of this method for evaluating pain sensitivity. This involves using a device to apply pressure and measure pain levels. Studies indicate that people with juvenile idiopathic arthritis (JIA) might feel pain at lower pressure levels than others, but the procedure itself is well-tolerated.
Overall, both cold pain tolerance and pressure pain threshold tests are safe and commonly used in pain research. They help researchers understand pain mechanisms without posing significant risks to participants.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it explores new ways to understand pain in kids with juvenile arthritis. Unlike standard treatments like NSAIDs or DMARDs, which focus on reducing inflammation, this study looks at how kids tolerate cold and pressure pain. By investigating these pain mechanisms, researchers hope to uncover insights that could lead to more effective and personalized treatment options in the future. Understanding these unique pain responses may open doors to innovative approaches that target the root causes of pain in juvenile arthritis.
What evidence suggests that this trial's treatments could be effective for juvenile arthritis?
Research has shown that children with juvenile idiopathic arthritis (JIA) often feel pain more easily than healthy children. For example, studies have found that kids with JIA have a lower pain threshold, experiencing pain at lower pressure levels, around 1.33 kg/cm², compared to their healthier peers. This means they feel pain more easily or intensely. In this trial, researchers will assess participants for cold pain tolerance and pressure pain thresholds to better understand these differences. Additionally, when treatments are tailored to meet specific goals, patients have reported significant improvements in managing their pain. These findings suggest that understanding how pain works can lead to better ways to reduce pain in children with JIA.678910
Who Is on the Research Team?
Hadas Nahman-Averbuch, PhD
Principal Investigator
Washington University School of Medicine
Are You a Good Fit for This Trial?
This trial is for children aged 9-17 with or suspected of having juvenile arthritis, and healthy controls. Participants must speak English and be able to understand study instructions. Pregnant or breastfeeding individuals, those with chronic pain conditions, or psychiatric conditions like ADHD, anxiety, depression are excluded.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Study Session
Participants complete a 2.5-hour study session involving psychophysical assessments of thermal and pressure stimuli, questionnaires, and potential biological sample collection.
Follow-up
Participants have the option to participate in additional follow-up study visits every 3 months and complete monthly surveys about their juvenile arthritis.
What Are the Treatments Tested in This Trial?
Interventions
- Cold pain tolerance
- Pressure pain thresholds
Trial Overview
The study measures how kids with juvenile arthritis perceive pain by testing their response to pressure and cold stimuli during a single session lasting about 2.5 hours. It also collects data through questionnaires on social factors and puberty stage, as well as saliva/blood samples for immune factor analysis.
How Is the Trial Designed?
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Treatment groups
Experimental Treatment
Inclusion: 1. Age between 9-17 2. Males and females 3. English speakers 4. Able to complete surveys and understand study instructions 5. Diagnosed or suspected of juvenile arthritis Exclusion Criteria Participants will not be enrolled if any of the following criteria exist and based on the investigator discretion: 1. Pregnancy or breastfeeding 2. (Control Group) Diagnosed with a chronic pain condition 3. (Control Group) Diagnosed with psychiatric condition including ADHD, anxiety, depression, etc.
Inclusion: 1. Age between 9-17 2. Males and females 3. English speakers 4. Able to complete surveys and understand study instructions 5. Healthy Exclusion Criteria Participants will not be enrolled if any of the following criteria exist and based on the investigator discretion: 1. Pregnancy or breastfeeding 2. (Control Group) Diagnosed with a chronic pain condition 3. (Control Group) Diagnosed with psychiatric condition including ADHD, anxiety, depression, etc.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Washington University School of Medicine
Lead Sponsor
Citations
Significant pain decrease in children with non-systemic ...
Significant pain decrease in children with non-systemic Juvenile Idiopathic Arthritis treated to target: results over 24 months of follow up.
Patient‐Reported Outcomes Among Patients Ages Two to ...
Clinical outcomes included 50% or greater improvement in JIA American College of Rheumatology (ACR) criteria, clinically inactive disease, and ...
Juvenile Idiopathic Arthritis and Pain
Studies have found that reduced quality of life and functional outcome (social, emotional, and physical), lowered mood, and poor sleep are all associated with ...
Assessment and management of pain in juvenile idiopathic ...
An evaluation of 521 children treated with methotrexate for six months reported dramatic improvements in pain, physical function and ability to participate in ...
Juvenile idiopathic arthritis: from aetiopathogenesis to ...
This review provides an overview of advances in understanding of JIA pathogenesis focusing on aetiology, histopathology, immunological changes associated with ...
Pain sensitivity in young adults with juvenile idiopathic arthritis
Raw data of cold pain threshold (CPT), heat pain threshold (HPT), and pressure pain threshold (PPT) were presented in median and dot-plots.
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rheumatologyadvisor.com
rheumatologyadvisor.com/news/altered-pain-perception-and-sensitivity-observed-in-patients-with-jia/Altered Pain Perception and Sensitivity Observed in ...
Among the JIA cohort, patients with inactive disease appeared to have higher pain sensitivity compared with patients with active disease.
Guidelines for the Cold Pressor Task as an Experimental ...
Abstract: The cold pressor task (CPT) involves placing a hand or forearm in cold water, a stimulus that produces a slowly mounting pain of mild to moderate ...
Pain experience in children with juvenile idiopathic arthritis ...
Anti-TNF agents have proven efficacy in children with severe juvenile idiopathic arthritis (JIA) who are unresponsive to standard therapy.
Juvenile Idiopathic Arthritis | PM&R KnowledgeNow
Range of motion: passive ROM exercises should NOT be performed in an inflammatory joint. Cold: pain relief, increase pain threshold, decrease ...
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