Arthritis Relief Blog

image source: arthritis.org

People often think that arthritis, or the disease characterized by the pain, swelling and stiffness of joints, is just for the older population of society. However, that is not the case. Arthritis is not just a disease of the old, and even children as young as 6 months can acquire this illness.

What is it?
Dr. Christine B. Bernal, who specializes in Pediatric Rheumatology, defines Juvenile Arthritis or chronic arthritis as the persistent inflammation of the joints for a period of more than 6 weeks in a child who is less than 16 years of age. By chronic, it means that the symptoms of the illness have been felt for a long period of time or have been frequently recurring.

“The exact cause of the illness is unknown,” says Dr. Bernal. However, studies have been shedding new light about the illness. “The current theory is that a patient with Juvenile idiopathic (or unknown) arthritis has a genetic susceptibility that is triggered by some known environmental cause,” she stresses. Putting it simply, one theory purports that a problem in a child’s genetic makeup and outside factors from the environment may be the root cause of the illness.

Other theories suggest that genetics plays a valuable role. Furthermore, theories also state that a child who is genetically predisposed or susceptible to juvenile arthritis may have greater chances of being affected by triggers in the environment because of his weak immunity. There are even some theorists who go as far as saying that behavior and nutrition during conception or pregnancy, as well as pollution and other factors from the environment contribute to a child’s acquisition of the illness. It’s a chicken-and-egg debate on nature vs. nurture when it comes to juvenile arthritis, and no definite cause can be pinpointed yet.

What are the symptoms of this illness?
There are three types of Juvenile Arthritis, according to Dr. Bernal. First is the Oligoarticular type, which is the kind of arthritis that affects four or less joints. Polyarticular type is arthritis that affects five or more joints. Lastly, Systemic type is the kind that affects any number of joints, is associated with fever, rash, enlarged lymph nodes, organomegaly (enlargement of internal organs in the body), and a high count of white platelets. “In the US, the oligoarticular type is the most common, but here in Asia, it’s the polyarticular and systemic which are more commonly seen,” she says.

The different types of juvenile arthritis are significantly different from each other. However, these three still share common symptoms. “The most common symptom is joint pains/stiffiness that is usually felt in the morning or with prolonged immobility,” Dr. Bernal stresses. A child may have limited movement due to swelling and pain in the joints.

Dr. Bernal emphasizes, though, that the diagnosis of this illness in a child is purely clinical. This means that to confirm if a child indeed has Juvenile Arthritis, the manifestations of the illness must be closely studied through a battery of physical examinations and laboratory tests.



How is the illness treated?
“The first line of treatment to alleviate pain and stiffness is through the use of anti-inflammatory medication,” says Dr. Bernal.  However, once diagnosed, other medications may also be used. “The conventional medications include NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) and DMARDs (Disease-Modifying Anti-Rheumatic Drugs)”. According to Medline Plus, a service of the US National Library of Medicine, NSAIDs are used when only a small number of joints are involved; while DMARDs are for children who have arthritis in many joints, or who have fever, rash and swollen glands. Advanced treatments are available for more complicated conditions.

Aside from your trusted pediatric rheumatologist, dietitians, bone surgeons, physical and occupational therapists may also be involved to help manage the symptoms of a child with juvenile arthritis.     

What else can be done?
Juvenile Arthritis is not an easy condition to treat for it involves prolonged medication. However, this illness can be managed smoothly if you:

a. Spot it early. Dr. Bernal couldn’t stress enough the importance of early detection. “If left untreated, kids with juvenile arthritis can develop permanent joint damage and eventually cause major disability,” she stresses. Early diagnosis means early treatment for the child, allowing him to maintain a good quality of life and prevent further complications from happening.  

b. Immerse yourself. “A thorough understanding of the disease is very important,” Dr. Bernal stresses. As much as you can, research on the disease, talk to medical experts, attend seminars, and always be on the lookout for updates on treatments and the like. Aside from having people who understand what you and your child are going through, a support group also serves as a network for sharing helpful information.

c. Don’t stop. According to Dr. Bernal, regular follow up and compliance with medications make all the difference for your child.  It takes discipline and dedication to commit to long treatments, such as the one for juvenile arthritis.  

d. Live healthy. Aside from exercises and activities recommended by your health care team, it is also important to live a healthy lifestyle.  “A healthy, balanced diet, and drinking 2 glasses of milk or calcium supplement for bone health is advised,” says Dr. Bernal. Make everyone in the family commit to this healthy lifestyle as well. 

e. Be there for your child. It can be very difficult and frustrating for a child to have his movements restricted or to put a limit to his everyday activities. More than the medications, making your child feel loved will allow him to cope with the illness more easily. Work closely with your child’s health care team and his school. Ask for updates, what can be done, how else you can help. 

While Juvenile Arthritis limits a child, his whole life does not have to be put on ball and chains as well. Even though kids get arthritis, a child and his family can still maintain a good quality of life with the proper management of the illness.