Everything You Need To Know About Juvenile Idiopathic Arthritis (JIA)

June 29, 2017

Everything You Need To Know About Juvenile Idiopathic Arthritis (JIA)

Arthritis or joint pain is something that we usually associate with older folks. However, arthritis is not only limited to adults. Kids can experience arthritis, too.

According to Arthritis Foundation, juvenile arthritis is an umbrella term used to describe rheumatic diseases in kids under the age of 16. There are many types of juvenile arthritis, the most common of which is Juvenile Idiopathic Arthritis.

 

What is Juvenile Idiopathic Arthritis?

Let's break the term down. Juvenile means young or has an early onset. Idiopathic means that the cause of the condition is unknown. Arthritis is the swelling of the synovium or the tissue found inside a joint. In that case, Juvenile Idiopathic Arthritis (JIA) is a type of joint pain that usually occurs in children 16 years old and younger, with no defined cause. This condition affects more than 50,000 children in the US alone.

 

What Are The Causes of JIA?

JIA is an autoimmune disease where the body's immune system attacks its own cells. The cause of the actual autoimmune reaction is unknown but according to Healthline, the following can predispose a person to this condition:

  • bacteria or virus
  • drugs
  • chemical irritants
  • environmental irritants
  • genetics

 

What Are The Types of JIA?

 

Systemic arthritis

This affects many or all body systems and is prevalent in both girls and boys. Since it affects multiple body systems, it hits internal organs like the heart, liver, spleen and lymph nodes but not the eyes. SA manifests in high fever and rashes on the trunk, arms, and legs.

 

Oligoarthritis

Also known as uveitis, iridocyclitis or iritis, oligoarthritis affects less than 5 joints in the body (usually the knee, ankle, and wrist) in the first 6 months. This type of JIA affects the eye (hence, the name uveitis, iridocyclitis or iritis) and is more prevalent in girls. 

 

Polyarthritis

As its name suggests, it involves five or more joints in the first 6 months. Usual joints affected include the jaw and neck, as well as the hands and feet.

 

Psoriatic arthritis

This occurs in children with both arthritis and psoriasis.

 

Enthesis related arthritis

This affects the places where tendons attach to the bones. Also affects spine, hips, and eyes and usually occurs in boys above 8 years old.

 

What Are The Signs And Symptoms of JIA?

Since there are many subtypes of JIA, the signs and symptoms vary from case to case. The following are the most common signs and symptoms of JIA, according to Arthritis Foundation:

  • Swelling and tenderness at joints - These are signs of inflammation. Vasodilation is the body’s way of trying to fight infection by pooling blood cells in an area. However, since this is an autoimmune disease, the body ends up affecting normal cells, too, making them swollen, tender and warm to touch. Inflammation in JIA may persist for several days or may come and go.
  • Fever - Fevers in JIA have a sudden onset and don’t occur in relation to any colds or flu.
  • Rash - Systemic JIA often manifests in rashes in the trunk and limbs.
  • Pain and stiffness - Kids often complain about having painful joints and muscles after a day full of activities. Kids who suffer from JIA, however, feel pain and stiffness in their joints immediately after getting up from bed or after long periods of inactivity. This may also manifest in limping, or favoring one side of the body when doing activities.
  • Decreased physical activity and fatigue- This is the result of pain and discomfort felt in the joints. Since most joints affected by JIA happen to be weight-bearing, the child’s activity decreases significantly. Because of the pain, the child exerts extra effort in doing simple everyday tasks, resulting in fatigue that could escalate into weight loss and eating problems.
  • Sleep problems - Pain in JIA often occurs after or during a period of inactivity, like sleep.
  • Swollen lymph nodes- This indicates infection, or in this case, an autoimmune reaction.
  • Eye problems- Oligoarthritis affects the iris.


How Do You Treat JIA?

Currently, there is no known cure for JIA. The goal of treatment is to stop the pain and inflammation and improve the child’s quality of life. This includes curbing the pain and discomfort through medication, therapy, and assistive devices. Experts also believe that with early diagnosis, a child with JIA can experience remission and can lead a normal life despite having the condition.

Medications for JIA include both steroidal and non-steroidal meds meant to relieve pain and inflammation, along with medications to prevent permanent damage to the bones and cartilage.

Eye inflammation can also occur in children with oligoarthritis, even if the joint pain has been controlled. Regular check-ups to the ophthalmologist are recommended.

Surgical methods are rarely used to treat JIA, especially during the early stages of the condition. However, it may be used to correct bone and joint deformities if the child develops them later in their life.

Custom-made orthotics, crutches, and other assistive devices may help the child regain balance and correct deformities made by JIA.

 

Home Treatment

Since researchers are still looking for the cure to JIA, the treatment plan mentioned above should be coupled with proper home management and care. This includes the following:

 

Pain Relief

An easy way to determine the severity of the child’s arthritis is morning stiffness. The longer it lasts, the more active the disease. Pain in the morning can be relieved through hot baths, doing range of motion exercises, or through hot and cold treatment. Using hot and cold packs alternately can reduce pain and swelling in the child’s joints.

 

Exercise

In the long run, JIA may affect the child’s mobility. Prevent this by letting them do a range of motion exercises and activities that can strengthen their bones and joints. This enables them to do daily activities, which increases their confidence and sense of independence. Low-impact exercises like swimming and biking can increase a child’s physical activity without putting a lot of pressure on their joints. Exercise also enables them to keep a healthy weight, which reduces stress on the weight-bearing joints in their back and lower extremities.

 

Nutrition

As mentioned above, children with JIA often suffer from fatigue and appetite loss due to their condition. Some may even have difficulty in eating if they experience pain in their jaw or fingers. A well-balanced meal should provide the child with adequate calories to keep their energy up. Nutritious food also prevents obesity, which can aggravate their condition.

 

Emotional Support

Having JIA is emotionally taxing for both child and parents. Normally, children play or socialize with peers through sports, dancing or other physical activities. If they have JIA however, this may not happen as often or not happen at all. The pain and discomfort felt by JIA patients may prevent them from having a “normal” life, so it is important to offer them emotional support. Direct caregivers can provide support and encouragement by developing a sense of independence in the child. Treating them as “special” could only draw attention to the condition; instead, children with JIA should be encouraged to do daily tasks. A sense of accomplishment can increase their confidence.

There are also a lot of support groups who organize activities like camps and conventions to increase the public’s awareness of the disease and to connect children who are experiencing the same condition.

 

In Closing

Arthritis can happen to adults and children alike. As a chronic condition, JIA has a big impact on the life of a child and their family members. The pain can oftentimes be debilitating. However, while it’s not easy to have JIA, many kids have proved that with proper treatment and care, this condition can be managed and they can lead normal lives.

 

Sources:

http://www.arthritis.org
http://www.kidsgetarthritistoo.org
http://www.webmd.com


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