Pain + Symptom Support
Helping your child stay comfortable, active, and engaged
Pain and symptoms can vary from day to day for children living with rheumatic disease. Some days may feel manageable, while others can be more challenging.
With the right strategies, tools, and support, families can help reduce discomfort, manage flare-ups, and support their child’s overall wellbeing. This page provides practical guidance to help you navigate symptoms and maintain a sense of normalcy in daily life.

Understanding Pain
Pain related to rheumatic disease is often caused by inflammation in the joints, but it can also be influenced by fatigue, stress, and overall disease activity. Every child experiences pain differently — some may have persistent discomfort, while others experience flare-ups that come and go.
It’s important to recognize that pain is not always visible. Children may struggle to describe what they’re feeling, or may try to push through discomfort to keep up with school or activities.
Learning how your child experiences pain — when it occurs, how long it lasts, and what helps — is a key part of managing symptoms effectively.
Managing Flare-ups

Flare-ups can happen unexpectedly and may involve increased pain, stiffness, fatigue, or reduced mobility. Having a plan in place can help you respond quickly and support your child through these periods.
During a flare, it can help to:
• Adjust activity levels and allow for rest
• Use prescribed medications as directed
• Apply heat or cold therapy to affected joints
• Focus on comfort and reducing stress
Over time, you’ll begin to recognize patterns and early signs of a flare, allowing you to respond sooner and reduce its impact.
“In the beginning, everything felt overwhelming — the appointments, the medications, the constant uncertainty. Connecting with other families through Cassie + Friends made a huge difference.”
— Parent, Cassie + Friends Community
Daily Symptom Management
Managing symptoms is not only about responding to flare-ups — it’s also about building daily routines that support your child’s comfort and wellbeing.
This may include:
- Maintaining a consistent sleep schedule
- Encouraging gentle movement and physical activity
- Supporting proper nutrition and hydration
- Creating routines that reduce physical and emotional stress
Small, consistent habits can make a meaningful difference in how your child feels over time.
Movement and Activity

Physical activity is an important part of managing rheumatic disease, even when pain is present. Movement helps maintain joint function, reduce stiffness, and support overall health.
That said, it’s important to balance activity with rest. Some days may require more flexibility than others.
Work with your child’s healthcare team to understand what types of movement are appropriate, and help your child learn to listen to their body — staying active without pushing too far.
Managing Fatigue
Fatigue is a common but often overlooked symptom of rheumatic disease. It can affect your child’s ability to participate in school, activities, and social life.
Supporting your child with energy management strategies can help:
- Build rest into the day when needed
- Prioritize activities that matter most
- Encourage open communication about how they’re feeling
Understanding fatigue as part of the condition — not a lack of effort — is important for both children and caregivers.

Supporting Emotional Wellbeing
Living with ongoing pain or physical limitations can affect a child’s mood, confidence, and sense of independence. Frustration, anxiety, or withdrawal are not uncommon.
Creating a supportive environment where your child feels heard and understood is just as important as managing physical symptoms.
“Bella was so excited to receive her gift, she put on the Cassie + Friends lanyard right away and I wear the Cassie + Friends pin to work every day” — Bella’s Mom
When to Seek Support
If your child’s pain is increasing, symptoms are changing, or daily activities are becoming more difficult, it’s important to reach out to your healthcare team.
They can help adjust treatment, recommend additional therapies, or provide guidance tailored to your child’s needs.
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Supporting Your Child, Every Day
Managing pain and symptoms is an ongoing process — one that evolves as your child grows and their needs change. With the right tools, support, and understanding, families can help children stay active, engaged, and confident in their daily lives.