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  • Open Access

Neurophysiologic pain response in patients with juvenlie idiopathic arthritis - a pilot study

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Pediatric Rheumatology201412 (Suppl 1) :P147

  • Published:


  • Pain Threshold
  • Pressure Pain Threshold
  • Quantitative Sensory Testing
  • Inactive Disease
  • Cold Pressor Task


Pain is a common symptom in children and adolescents with JIA. It has been hypothesized that frequent pain experiences sensitize pain processing pathways, resulting in hypersensitivity to later painful stimuli. A lower pain threshold (PT) and pain tolerance in JIA patients have been demonstrated in previous studies using pressure algometry and the cold pressor task.


To investigate pain thresholds in adolescents with JIA compared to age and sex matched healthy controls, using several modalities for experimental pain testing.


Consecutive adolescents with JIA (16-18 years) were recruited from the pediatric rheumatology outpatient clinic at St. Olavs Hospital. Healthy controls were recruited from a local upper secondary school. Both completed a validated questionnaire on health and quality of life (SF-36), and reported pain from the last week (VAS scale). Quantitative sensory testing was conducted, and thermal detection pain thresholds (PTs) recorded. A thermal element was held against three specified locations of the participant’s skin, and the participant was instructed to press a button when he/she felt changes in temperature or pain. Pressure algometry was performed on two well-defined anatomical areas, giving the pressure pain threshold (PPT).


Compared to 19 healthy controls, the 14 patients with JIA reported more pain during the last week, and had a less favorable score in the physical SF-36 domains, but no difference in the mental health domains. They displayed a lower PPT, but similar cold and warmth PT compared to the controls. When subdividing JIA patients with active and inactive disease, patients with inactive disease had a lower cold PT and PPT, and a tendency towards a lower heat PT compared to controls. Patients with active disease had a tendency towards higher PTs in all three modalities compared to both healthy adolescents and patients with inactive disease.


Our results indicate that JIA patients may be subject to a sensitization, giving lower pain thresholds in inactive disease, but once the disease is active, painful arthritis may act as a diversion leading to increased rather than lowered PT.

Disclosure of interest

None declared.

Authors’ Affiliations

Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
Department of Pediatrics, Hospital of Levanger, Levanger, Norway
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
Department of Neurology and Clinical Neurophysiology, University Hospital of Trondheim, Trondheim, Norway
Department of Pediatrics, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway


© Iversen et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.