Grad Profile
Understanding the symptoms of JIA

September 19, 2008

By Brette Ehalt

Juvenile Idiopathic Arthritis (JIA) is the most common chronic disabling disease of childhood, and Susan Tupper, a community health and epidemiology PhD student, is on her way to a better understanding of its symptoms.

Tupper is studying the pain experienced by children with JIA. Specifically, she is looking at the "within day" fluctuations of pain, because these fluctuations may help determine possible sources of pain aggravation as well as point to potential treatments.

"I want to see if there are predictable patterns to this pain," says Tupper. "Patterns in adults with arthritis have been documented, but no one has looked for patterns in children with arthritis. And if there are patterns, I want to know what drives them."

Beginning this fall, Tupper will be working with Dr. Alan Rosenberg, Saskatchewan's pediatric rheumatologist, to recruit 40-50 children and adolescents who will carry a hand-held electronic diary device; three times a day, over a period of three days, the device will prompt the participant to record information.

"When the alarm on the device sounds, the child will be asked to enter his or her level of pain intensity, pinpoint the pain's location on a body diagram, describe the pain (using words like aching, burning, stabbing, etc.), and note other details such as stiffness, fatigue, and mood," Tupper explains. "Each entry will take about five minutes to complete."

The entries will then be analyzed for rhythms and relationships regarding the aforementioned factors.

Tupper was inspired to pursue this project after working with adults who have chronic pain. "I was intrigued by the influence of pain in childhood on adult pain experiences. Unmanaged or poorly managed pain in childhood has long-term consequences for how pain is felt in later years."

After graduating in 1992 with a BSc in Physical Therapy from the University of Western Ontario, Tupper worked in private practice in Vancouver and Saskatoon. In 1998, she began working as a physiotherapist at Saskatoon City Hospital in the Kinetik and FIT for Active Living Programs. Soon after, she helped with the development and set-up of the health region's Chronic Pain Centre.

Currently, Tupper is a trainee with Pain in Child Health, a Canadian Institutes of Health Research-funded initiative, and is involved with the campus Research Group on Pain in Childhood and the Institute for Child and Adult Arthritis Research.

"It's important for me to stay active within the research environment. It helps to stimulate new ideas and maintain focus," says Tupper. "The study of pain in childhood is still in its infancy and it truly is an exciting multidisciplinary field."

Brette Ehalt writes profiles of grad students for the College of Graduate Studies and Research.