JIA or juvenile idiopathic arthritis is one of the most abundant arthritis types that is reported in young children. Idiopathic literally means ‘of unknown origin’. In order to differentiate it from rheumatoid arthritis, JIA was given a separate term so that it may be studied more accurately.
According to latest estimates, the current incidence of young children with arthritis is 12.6 cases per 100,000 children (under 18 years of age) each year. Currently more than 80,000 children are living with an active form of arthritis in United States alone, the prevalence is much higher in certain under-privileged communities and parts of the world.
What Should You Know About Juvenile Arthritis?
JIA is characterized by the autoimmune response of the body when it begins to attack its own tissues, leading to inflamed joints and inflammatory response across other tissues of the body. But, it is definitely not a contagious disease. Children suffering from JIA have the following clinical presentation:
- Warmth and redness of affected joints (mostly small joints of hand and feet) in addition to major weight-bearing joints of the body like knee, wrist and elbow.
- Stiffness, swelling and pain that may compromise physical mobility and function.
- At times the pain is highly aggravated leading to periods of inactivity or sleep.
Other symptoms may include sleep disorder, limping, rashes on the midsection of the limbs, fatigue, fever, decreased appetite, weight loss and swollen lymph nodes. A paediatrician, upon receiving complaints regarding such symptoms, begins the regular monitoring and may refer the child to the paediatric rheumatologist.
In order to help your child to be physically active during periods of illness, it is very important to learn about the disease process itself.
What Causes Juvenile Idiopathic Arthritis?
Till now, it is not yet exactly defined how JIA is caused. No solid proof has been obtained regarding the association of vitamin deficiency, allergies, toxins or foods being the culprit behind JIA. However, a very recent study has suggested that JIA may be liked with genetic predisposition.
Many genetic markers have recently been identified in case of JIA and nearly 100 more under consideration. Nevertheless these genetic markers solely can not assist in predicating who might or might not get affected by JIA. Researchers have a belief that virus may serve as a trigger of JIA in children who already have genetic tendencies.
Early Sign And Symptoms of JIA
Given below are the symptoms that are commonly experienced by the sufferers of JIA. However, these symptoms may vary from child to child and it is not necessary that one child may experience all of these symptoms.
- Changes in the pattern of physical activity
- Stiffening of the body particularly after waking up in the morning
- Pain upon exertion or during rest
- Preferring one limb on the other one
- Swollen and tendered joints
- Joints may feel warm upon touch
Correct Diagnosis And Differentiation Of JIA From Related Rheumatic Ailments
According to the data reported by Centers for Disease Control, juvenile rheumatoid arthritis is the most frequently reported variety but there are an additional 150 conditions that may present with joint dysfunction and arthritis symptoms.
It is very important to differentiate the related joint related ailments in order to diagnose JIA correctly. Listed below are few other rheumatoid diseases that are more or less similar to JIA and are found commonly in children:
- Juvenile Lupus: Just like JIA, lupus is also an autoimmune disease that directly affects the blood, kidneys, skin and joins along with some other body parts.
- Juvenile Scleroderma: Scleroderma is actually the medical term used for a number of conditions that make the skin of the face, forearms, hands and fingers to become hardened and tightened. However, it is capable of affecting other body parts as well such as joints, nerves, muscles, kidneys, lungs, digestive system, blood vessels and skin.
- Juvenile Dermatomyositis: Juvenile dermatomyositis, abbreviated as JDM, is characterized as an inflammatory disease that results in weakened muscles and a skin rash on the knuckles and eyelids.
- Juvenile Vasculitis: Vasculitis is the disease that involves inflammation of the blood vessels and can appear in many forms. Symptoms associated with joints may occur in each of the above type.
- Non-inflammatory conditions in children: Sometimes joint pain or recurrent or chronic muscle pain may occur in children due to the non-inflammatory musculoskeletal conditions such as fibromyalgia.
7 Tips To Help Your Arthritis Child To Remain Physically Active
Tip # 1: Lifestyle Modifications
Quite often, parents fail to come up with the ideal lifestyle modifications that will help their JIA-suffering child to cope up with the condition. A great deal of physical activity, proper diet and other factors may encourage the child to live up to the everyday challenges that they might face.
Listed below are some easy guidelines that can be adopted to bring back the child’s life to normal up to a certain extent. One of the simplest ways to determine the state of your child’s JIA is by checking the stiffness. If it lasts for a short time period, then the disease is not in quite an active state.
Following tips may help alleviate the stiffness:
- Taking a hot shower or bath.
- Napping in a sweat-suit or a sleeping bag.
- Addition of motion range exercises in the daily routine.
- Treating with cold therapy or hot therapy.
Tip # 2: Physical Activity
One of the most mandatory parts of lifestyle modification involves inclusion of variant exercise in the daily routine of your child. They not only restore the muscle tone and keep the bones strong, but they also assist in preserving the motion range. Strategic exercise plan will also help your child achieve and then maintain healthy weight according to his age. This will definitely alleviate the extra pressure that is placed on the weight-bearing joints like ankles, hips and knees.
Study reported in Current Opinion In Rheumatology suggested that children who suffers from juvenile arthritis have compromised anaerobic as well as aerobic capacity to perform normal physical activity (especially when compared to normal peers).
However, if physical activity is compromised, the risk of disability and de-conditioning of joints increases. The report also suggested that in the absence of regular physical activity, bone mineral density of these individuals is severely compromised that may lead to fractures, osteoporosis, bone defects and functional disabilities.
Tip # 3: Therapeutic Exercise
Occupational as well as physical therapy may help together in the restoration and maintenance of the movement of joints. Performing therapeutic exercises will assist in preserving the strength and motion range, enabling the child to carry out the routine tasks with ease. Motion range exercises are very beneficial in case of joint stiffness and keep the joints from become all bent and fixed.
Joints having poor movements have elevated chances of developing osteoarthritis regardless of the resolution of inflammatory response. The strength of the muscles can be built by some strengthening exercises which ultimately help in supporting the joints that are weak.
- Occupational or a physical therapist will guide the child properly regarding how to carry out these therapeutic exercises while he is at home.
- Most of the therapeutic exercises need to be performed on the daily basis.
- Prior to exercise, hot or cold treatment may help in preparing the joints for the exercise.
- Make sure being a parent, you play the vital part in motivating your child so that he or she will not give up.
Well-programmed therapeutic fitness regimens optimizes joint motion, muscle strength and grip along with overall emotional and physical well-being. Rope skipping and free-weights are some of the safest regimens that can be performed even at home.
Tip # 4: Recreational And Sporty Activities
Recreational activities allow the child to enjoy the quality time with friends and family, by having a huge scoop of fun and simultaneously exercising his joints and muscles. These activities assay an important role in developing confidence in child’s own physical abilities. Nonetheless do not let your child replace therapeutic exercises with recreational activities. Both of them hold equal significance in their own perspective.
Motivate your child to indulge in activities like bike riding and swimming as they exercise the muscles and joints without actually subjecting a lot of pressure on the weight-bearing joints. It is considered wise to keep you child from jogging or jumping on the trampoline. If the arthritis of your child is being well managed, then allow him to taste a bit of sports such as letting him play soccer or basketball.
Tip # 5: Take Extra Care Of His Nutrition
A proper, nutritious, healthy diet is necessary for all children, whether or not they are suffering from JIA. Some of the cases have yielded that by addition or elimination of certain foods, alleviation or aggravation of symptoms can be result. However there is no hard and fast diet protocol for most arthritis patients.
- Limit the junk food: Make sure your child consumes a diet that does not contain saturated fat and processed foods. Instead, their diet must comprise of beans, nuts, fish, vegetables and fresh fruits as they maintain the overall health of the child which ease down the inflammation.
- Maintain adequate body weight: Both weight gain and weight loss are linked with JIA. Loss of appetite or anorexia may contribute to the weight loss. On the other hand, some children with JIA may put on a lot of weight. This may be due to the use of corticosteroids or minimized physical activities in their daily routine. Putting on weight is like subjecting your joints to extra stress especially those of hips and knees.
- Maintain optimal calorie intake in special cases: For children who have their jaws affected, chewing food may become very difficult. Consuming, smaller meals and snacks, rich in nutrition, may assist the child in getting just the right calories that his body requires. Make sure each bite is rich in nutrition so that you may cut down the amount of food consumed by your child during every meal. Make sure you consult a professional dietician to carefully design an ideal diet for your child that will meet his body requirements.
Tip # 6: Teach Your Child How To Cope With A Flare
Flare is commonly observed when the arthritis is in its most active state. This will present with symptoms like fatigue and swollen, painful, stiffened, pink joints. Seek medical help right away if you feel like your child is having a flare. Given below are some quick tips to assist your child’s flare:
- Make sure your child does not skip any medicine when it is the medication time. This way flare can be prevented that may result from skipping of any dose.
- Apply cold packs on sore joints for like 20 minutes for 2-3 times with the interval of 10 minutes.
- After the initial 24 hours, hot packs may be more relieving.
- Bring changes to your child’s routine activities as per need. However, make him continue all the activities that involve restoration of range motion and flexibility of joints.
- Make your child rest more often especially when he is in pain.
- You may consult the paediatrician if your child may use splints during night time.
- Make sure your child does not drop out of his socializing circle to isolate himself. Let him hang out with friends and family to distract him from his pain.
Tip # 7: Treating The Emotional Side Of JIA
Once your child is diagnosed with JIA, he gets significantly influenced by his disease both emotionally and physically. Make sure you encourage your child to cope up with the emotional roller coaster linked with arthritis as this will not only let him live a peaceful life but it will also be beneficial for the entire family. A few guiding tips are:
- Motivate your child to understand the full details of his disease and the treatment protocol so he would not feel left out while you make any decision regarding his disease.
- He must also feel like he has a say-so in his condition.
- Do not stop your child from being too emotional by expressing his sorrow or rage.
- Make sure you do not pity him and isolate him from the world.
- Treat him like the rest of your children and let him carry out the responsibilities just like how you let your other children.
- Allow your child to speak to you or a counsellor about his queries, questions and concerns regarding his illness.
To conclude, if your child is suffering from the juvenile arthritis, caution and care is needed because about 50% children experience growth restriction and short stature in the absence of optimal care and support. Additionally, about 30% JIA children develop functional and physical impairment that may affect with their long-term health within 10 years of the onset of arthritis.