Hundreds of thousands of kids and teens in the United States live with juvenile idiopathic arthritis (JIA) or other pediatric rheumatic diseases. These autoimmune diseases affect not only joints but also skin, eyes and internal organs. A diagnosis can be scary, but effective treatments are available.
Juvenile arthritis refers to rheumatic diseases in children aged 16 and younger. These diseases are not just adult diseases in children; they have many distinctions and are treated differently than in adults. The most common is juvenile idiopathic arthritis (previously known as juvenile rheumatoid arthritis), and they include juvenile psoriatic arthritis, pediatric lupus and a number of others.
Most kinds of JA are autoimmune or autoinflammatory diseases. That means the immune system, which is supposed to fight against foreign invaders like viruses and germs, instead releases inflammatory chemicals that attack healthy cells and tissue. In most JA cases this causes joint inflammation, swelling, pain and tenderness, but some types of JA have few or no joint symptoms or only affect the skin and internal organs.
The exact causes of JA are unknown, but researchers believe that certain genes may cause JA when activated by a virus, bacteria or other external factors. There is no evidence that foods, toxins, allergies or lack of vitamins cause the disease.
Here are some of the symptoms and health effects of JA:
Joints: May cause joints to look red or swollen and feel stiff, painful, tender and warm. This can cause difficultly moving or completing everyday tasks. Joint symptoms may worsen after waking up or staying in one position too long.
Skin: Skin symptoms may include a scaly red rash (psoriatic), light spotted pink rash (systemic), butterfly shaped rash across the bridge of the nose and cheeks (lupus) or thick, hardened patches of skin (scleroderma).
Eyes: Dryness, pain, redness, sensitivity to light and trouble seeing properly caused by uveitis (chronic eye inflammation).
Internal organs: Can affect internal organs such as the digestive tract (diarrhea and bloating), lungs (shortness of breath) and heart.
Other symptoms: Include fatigue (feeling extremely tired or rundown), appetite loss and high spiking fever.
Diagnosis
A pediatrician may start to determine what’s causing symptoms, but parents may be referred to a rheumatologist, a doctor with specialized training in treating arthritis. Some rheumatologists treat only children, while others treat only adults, and others treat both.
The doctor will ask questions about the child’s medical history, when symptoms started, how long they have lasted and about the child’s family history. He or she will also perform a physical exam to look for signs of JA, like limited range of motion, rash, eye symptoms and joint swelling, tenderness and pain.
Diagnostic tests include laboratory tests that look for inflammatory markers and imaging (X-rays, CT scans, MRIs) to look for signs of joint damage and help rule out other causes, like trauma or infection.
There is no cure for JA, but with early diagnosis and aggressive treatment, remission (little or no disease activity or symptoms) is possible.
The goals of JA treatment are to:
- Slow down or stop inflammation and prevent disease progression.
- Relieve symptoms, control pain and improve quality of life.
- Prevent or avoid joint and organ damage.
- Preserve joint function and mobility for adulthood.
- Reduce long-term health effects.
A well-rounded plan includes medication, physical activity, acupuncture, massage, mind-body therapies) and healthy eating habits.
Self-Care
It’s important that children and teens make healthy lifestyle choices and use complementary therapies to manage the pain and stress of arthritis. These include:
Healthy eating. Eating some foods, like those found in the Mediterranean diet (i.e. fatty fish, fruits, vegetables, whole grains and extra virgin olive oil), and avoiding others (high-fat, sugary and processed foods) may help curb inflammation.
Hot and cold therapies. Heat treatments, such as heat pads or warm baths, work best for soothing stiff joints and tired muscles. Cold is best for acute pain. It can numb painful areas and reduce inflammation.
Topicals. Creams, gels or stick-on patches can ease the pain in a joint or muscle. Some contain the same medicine that’s in a pill, and others use ingredients that irritate nerves to distract from pain.
Mind-Body Therapies. Meditation, deep breathing, distraction techniques (listening to music or reading) and practicing visualization can help relax and divert attention away from pain, especially during shot time.
Massage and Acupuncture. Massage may help reduce pain and ease stress or anxiety. Acupuncture involves inserting fine needles into the body along special points to relieve pain. If there’s a fear of needles, acupressure, which uses firm pressure, may be used instead.
Supplements. The use of supplements is rarely studied in children, but some supplements that help adults may help children, too. Ask a doctor about which supplements and vitamins may be helpful and which ones may cause side effects and medication interactions.
Stress and Emotions. Kids and teens with chronic diseases are more likely to get depressed. Therapists and psychologists can help kids deal with tough emotions and teach positive coping strategies. A strong support system of friends and family can also provide emotional support during tough times.
For more information visit https://www.arthritis.org/diseases/juvenile-arthritis.