What is juvenile arthritis ?

Juvenile   arthritis is a general term that describes all types of arthritis diagnosed in someone under the age of 16 years. Other names for juvenile arthritis include juvenile rheumatoid arthritis, juvenile chronic arthritis,juvenile idiopathic arthritis and Still’s disease. Around one in 1,000 children have some form of juvenile arthritis, it is more often seen in girls and is one of the most common chronic conditions to affect children.  The symptoms can develop in children at any time and may last for months or years, although most children are recovered by adulthood. The cause of juvenile arthritis is not known but we do know it is an auto immune disease.  In juvenile arthritis, the immune system attacks the lining of the joints, causing inflammation and joint damage.

What are the symptoms of juvenile arthritis ?

Symptoms may vary in each child but are likely to include:

•     swollen, red or hot joints
•     joint stiffness especially in the morning
•     recurrent pain in one or more joints
•     movements of joints become more difficult
•     in systemic cases rashes, fever and feeling unwell
•     visual problems

Types of juvenile arthritis

There are different types of juvenile arthritis including

•     polyarthritis _ where 5 or more joints are effected
•     pauci-articular arthritis where 4 or less joints are effected
•     systemic juvenile arthritis where the organs as well as joints are effected
•     unclassified juvenile arthritis this is where the condition does not fit any of the types of arthritis

How is it diagnosed ?

Juvenile arthritis is diagnosed using a number of tests and examinations including:

•     medical history
•     physical examination
•     blood tests (however most children diagnosed with juvenile arthritis do not have a positive result)
•     X-rays and scans
•     eye examination

Treatment of juvenile arthritis

In the majority of children early diagnosis and treatment resolves in a good outlook for the child.  There is usually a team involved and this may include Doctors, nurses, physiotherapists, occupational therapists, podiatrists,dieticians, social workers, and psychologists.  Treatment needs to be tailored to each child and family as there are different types and each child is effected differently.Treatments may include medications, injections and therapy. The ultimate goal of therapy is remission (inactive disease). Doctors now, more than ever with the variety of treatments available are able to achieve this.

What we can do …

We understand that juvenile arthritis can be painful and distressing for your child. Our team of specialist Paediatric Physiotherapists & Occupational Therapists can provide assessment and treatment for your child to help relieve their symptoms and improve their function.

The effects of juvenile arthritis can significantly impact on a child’s life and functional abilities. Painful, stiff joints can lead to inactivity and muscle weakness which if left untreated can impair a child’s ability and potential for recovery. Physiotherapy aims to:

•     reduce pain
•     reduce swelling
•     improve range of movement
•     reduce joint stiffness
•     improve muscle strength and length
•     improve function and independence
•     improve mobility

Our specialist paediatric physiotherapists will assess and tailor treatment according to the child’s needs. Treatment is designed to maximise a child’s independence and may include:

•     advice regarding pain management strategies e.g. use of heat or ice
•     gentle stretching exercises to reduce muscle stiffness
•     mobilising exercises to improve joint range of movement
•     strengthening exercises to improve muscle strength
•     exercises to improve stamina and exercise tolerance
•     hydrotherapy to work on all of the above
•     advice on appropriate activities outside therapy e.g. swimming
•     home exercise programme and advice on long term management

In addition to the above, our specialist Paediatric Occupational therapists will assess and tailor treatment according to the child’s needs and may include :

• adaptation of activities such as writing using equipment to reduce fatigue and improve outcomes
• assist in managing pain by splinting or taping as required
• advice on equipment for home and school to aid self care routines and mobility

What you can do ?

Arthritis is a disease that wants your child to sit still. You’ve got to help them to beat it by staying active. It is so easy to let their pain keep them on the couch or in your arms. But in the long run, not exercising is worse and can create more pain, making everyday activities like walking or
playing painful.

Help them do their BONEWORK

They may not always feel like moving – especially when they are feeling stiff and sore. Let them take it easier during those times, but try to get
them to do what they can, even if they do just a little bit. Make their exercise program a part of the daily routine like brushing their teeth or doing homework. Whatever time of day you choose is the time… just do it.

You can assist by providing heat, access to the pool and providing praise for all attempts to carry out their exercise and strengthening program.