Juvenile arthritis is one of the most common chronic childhood conditions, affecting nearly 300,000 children in the United States, according to the FDA.
The disease causes the immune system to attack its own tissues, resulting in pain, swelling, tenderness and stiffness in the joints. These symptoms usually begin before children are 16 years old and include:
- Joint pain that worsens in the morning and improves during the day
- Limping, as well as pain in hands and feet
- Swelling in the joints and lymph nodes
- Irritability, fatigue or apathy toward playing with others
- A "hot" sensation in the joints
- Weakness of the muscles and tissues surrounding the joints
- A very high fever and a light pink rash, which occur infrequently and tend to go away quickly
Treating Juvenile Arthritis
Treatment aims to control swelling, relieve pain and control joint damage. Medications can help children have full physical function. Polyarticular JRA may even become inactive in children who begin medications within 2 years of onset.
The risks: many medications work by suppressing a child’s immune system. This can increase the chance of serious infection.
Medication Options
Generally, doctors attempt to ease symptoms with medications that suppress the immune system or ease inflammation. These include:
- Biologics — Injected or given through an IV, biologics target molecules that cause inflammation as well as proteins that stimulate the immune system
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — help swelling and pain
- Disease-modifying antirheumatic drugs (DMARDs) — slow the progression of the disease
- Tumor necrosis factor (TNF) blockers — decrease swelling, pain and joint stiffness
- Interleukin inhibitors — reduces disease activity
- Corticosteroids through IV or by mouth — for swelling
- Steroid injections into the joint — may help relieve swelling and pain in some children
Physical Therapy
Exercise offers several benefits to children with juvenile arthritis: Strong muscles support joints, easing pain and promoting a full range of motion.
In addition to physical therapy, we often encourage children to engage in normal daily activities, non-contact sports and other recreation.
Maintenance Devices
Splints and other devices can keep bone and joint growth normal, as well as prevent some joints from freezing in a bent position.