Team Care Critical in Treating Juvenile Arthritis
Published Online: Tuesday, July 16, 2013
Pediatric rheumatologists, physical therapists, ophthalmologists, and dentists are among the health care professionals who play a role in treating juvenile arthritis patients.
There is no cure for juvenile arthritis, but treatment can help stop the progression of the disease. Through a combination of medication, physical activity, and healthy eating habits, joint inflammation can be relived and pain can be controlled, improving the overall quality of life for children diagnosed with the condition. Because treatment plans for juvenile arthritis involve treating the condition as well as preventing and treating complications, care is often managed by a team of clinicians, including a pediatric rheumatologist, physical therapist, ophthalmologist, and dentist.
A rheumatologist can recommend and prescribe different types of medication to treat juvenile arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, can help relieve pain and inflammation. NSAIDS are often the first type of medication used in treatment and are available in over-the-counter and prescription-only forms.
If NSAIDs are unsuccessful in relieving arthritis symptoms, disease-modifying anti-rheumatic drugs (DMARDs) may be the next step in treatment. Methotrexate is the most commonly prescribed DMARD to children with arthritis and is generally effective in slowing the progression of the disease. DMARDs may take several weeks or months to affect symptoms and, therefore, are usually taken in conjunction with an NSAID.
In more severe cases, corticosteroids may be prescribed and given intravenously or by mouth to stop serious symptoms such as pericarditis, or inflammation of the sac around the heart. Physicians are often hesitant to prescribe these medications to children as they can interfere with normal growth, weaken bones, and increase patients’ susceptibility to infections. If corticosteroids are prescribed, physicians will gradually wean the child off the medication once their symptoms are controlled.
Biologic response modifiers, or biologic agents, are a newer class of drug treatments that may be given to children who are unresponsive to other arthritis treatments. These drugs block inflammatory proteins such as interleukin-1.
In addition to medication, many children with juvenile arthritis receive physical therapy, which can help maintain muscle tone and preserve or recover joint motion. Regular exercise is also important, as it promotes muscle strength and joint flexibility. Swimming is particularly good exercise for children with arthritis as it exercises their joints with minimal stress.
Children with arthritis should also have regular eye and dental exams. Certain arthritis medications and some forms of arthritis can affect the eyes, potentially causing serious complications. Ophthalmologists can help to detect and treat eye inflammation. Children whose arthritis affects their hands may have a difficult time brushing and flossing their teeth properly. Due to the effects of arthritis on their jaws, other children may not be able to open their mouth fully to brush and floss. Regular dentist visits can help preserve oral health in these children.
Maintaining a healthy diet is another critical component of juvenile arthritis treatment. Arthritis medications may cause some children to have poor appetites, while they may cause others to gain weight. A balanced diet can help ensure that children maintain a normal body weight. Children with juvenile arthritis also need to eat foods rich in calcium, as they are at an increased risk of developing osteoporosis.
Parents can also help to relieve their child’s symptoms by applying cold or hot packs to affected areas.
With help from a team of clinicians and the support of their family, children with juvenile arthritis can achieve controlled symptoms and enjoy improved quality of life.