Juvenile Rheumatoid Arthritis
Juvenile rheumatoid arthritis is a disease not so commonly discussed, leaving most of us little knowledge about its effects, treatments, or severity. Although we generally think of arthritis as a disease of the aging, juvenile arthritis is a reality that causes joint inflammation and stiffness for more than six weeks in a child of sixteen years of age or less. The inflammation causes redness, swelling, warmth, and soreness in the joints. Some may even experience affects on their internal organs such as the heart, spleen, liver, and lymph nodes. Although most people don’t realize it, juvenile rheumatoid arthritis is an autoimmune disorder. The immune system, which normally helps to fight off harmful foreign substances such as bacteria or viruses, begins to attack healthy cells and tissues. Scientists aren’t sure of the cause, but they suspect it is something in the child’s genetic makeup that develops problems with his joints and bones. Sometimes the trigger may be an environmental factor such as a virus that triggers development of pain. Persistent joint swelling, pain, and stiffness are typical, and commonly affects the joints in the hands and feet. It seems to be worse after sleeping, so one of the earliest signs of juvenile arthritis is often limping in the morning because of an affected knee. Often the symptoms flare up and down, called remissions flare-ups. Some children experience one or two flare-ups and are never bothered again, while some have many flare-ups or have symptoms that never go away. The symptoms usually present when a doctor sees a child are: persistent pain or swelling of joints, an unexplained rash and fever, or an unexplained limp. Joint swelling or pain must exist for at least six weeks for juvenile arthritis to be considered as the cause. For this reason, it is helpful for the parents to keep a record of when the symptoms first appeared. Blood tests and x-rays are useful diagnostic tools when trying to decide if a child is afflicted with this disease.
When a child has juvenile rheumatoid arthritis, treatment by a rheumatologist is necessary. A team approach, with a pediatrician, rheumatologist, and physical therapist, provide optimal treatment. Non steroidal anti-inflammatory drugs are often prescribed to reduce the swelling, and in severe cases, additional disease-modifying medicines are given. Physical therapy is an important part of the child’s recovery plan. Exercise keeps the muscles in tone and can preserve the range and motion of the joints. Some people seek alternative ways of treating arthritis, such as special diets or supplements. These methods have not been found particularly helpful, but they aren’t harmful either. A child may be helped by some of the alternative approaches by relieving the stress of living with a chronic illness. Doctors stress it is important not to neglect the regular health care treatment.
The entire family is affected when a child has juvenile rheumatoid arthritis, and there are things the family can do to help the child to cope. First, treat the child as normally as possible by keeping him involved in family activities. The parents must keep close communication with the child’s physician so that medicines can be balanced to treat the symptoms. Parents should encourage exercise and physical therapy, and during remissions, let the child be involved in team sports to help keep the joints strong and flexible and provide playtime with other children. The family can also work closely with the school so that school officials understand that the child may be absent for long periods of time and will need at-home lesson plans to keep up while he is ill. Allowing the child to leave class just a little earlier to give him more time to get to the next class is another important modification.
The disease should be explained to the child’s classmates, so everyone understands what’s happening to their friend. Children can be very supportive of one another when they understand what’s going on. Children should understand that getting a disease is no one’s fault. Sometimes children get the notion that a child is being punished for something he did when he gets sick. There are also support groups to help a child cope with juvenile rheumatoid arthritis by talking to others who share his experience. There are groups for the entire family as well, which helps them cope with the special stresses that occur. Whether it is a short-lived problem, or a lifelong one, children can be helped when they are stricken with the strange and painful disease called juvenile arthritis. Psalm 127:3 tells us, “Children are a heritage of the Lord.” We as believers all have a responsibility to care for those little ones who touch our lives. Helping them struggle those discouraging times with their disease is important for each of us.