Integrated pain management in a child with arthritis in Cape Verde: a case report

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Introduction: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood, often associated with persistent pain, functional disability, and a negative impact on quality of life. Pain management is challenging, requiring multidisciplinary approaches that integrate biological, psychological, and social factors. Case presentation: This case report presents a clinical case of a 10-year-old male admitted for progressive polyarthritis with severe pain and an inability to walk. Laboratory and imaging tests confirmed enthesitis-related JIA (HLA-B27 positive). During a nine-month hospitalisation, pharmacological and non-pharmacological interventions were implemented, resulting in partial improvement and recurrent episodes of pain, leading to referral for biologic therapy at a specialized centre. Discussion: This case illustrates the complexity of chronic pain in JIA, with significant functional, emotional, and behavioural repercussions. Psychosocial factors and family involvement influence the experience of pain. Integrated, multidisciplinary, child-centred strategies that combine pharmacological and non-pharmacological interventions with emotional support are essential for effective management. Conclusion: In settings with limited resources, the lack of biologic therapies requires referral networks to ensure access to specialized care. This report highlights the importance of multidisciplinary, child-centred approaches to optimize the management of chronic pain in JIA.

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