We should not forget that children can experience pain on a chronic basis. Joint pain is a leading cause of disability in children with arthritis, even after definitive treatment for the arthritis has been initiated. Pain limits the activities of children, disrupts their school attendance, and affects the emotions. Studies have shown that even the smallest decrease in the severity of pain can result in a significant increase in a child's sense of well-being.
Chronic pain in children with arthritis stems from a combination of biological phenomena, psychological factors, and the cultural milieu. Continuous pain can actually result in changes in the nervous system, which in turn can have an impact on potential future disability. The degree of active arthritis does not necessarily correlate with the amount of pain: other factors that play a role in pain include the child's age, ability to cope, level of development, mood, and levels of stress with which the child must deal.
It is the job of the physician to gain a thorough understanding of the nature of the pain the child experiences, and the impact the pain has on the child's life: How does this pain affect school work, play, interactions with others, sleep, etc.?