Juvenile Arthritis – St Leonards Physiotherapy

Arthritis

Arthritis is commonly thought of as a condition for older people but children can get arthritis too. Wear and tear on our joints, or osteoarthritis, affects many of us as we age. Childhood arthritis, called Juvenile Idiopathic Arthritis (JIA), affects around 1 in 1,000 children under the age of 16.

There is no known cause of Juvenile Arthritis.  But what is known is it’s an autoimmune disease where the immune system starts attacking the joint linings.

This can cause inflammation, swelling, increase in synovial fluid (the fluid that lubricates our joints) and joint damage. These joint changes cause pain, stiffness especially in the morning, restriction in joint movement and reduction in general mobility.

If the inflammation is not treated there can be damage to joint cartilage and bone. Pain and stiffness leads to less use which results in muscle weakness and loss of freedom of movement. Most common joints affected are the knees, ankles, wrists and fingers. My role as a paediatric physiotherapist is to help in the diagnosis of children who present with often severe restriction in movement, and then to help them get moving again.

Even toddlers get Juvenile Arthritis. They may suddenly stop walking or have a strong painful response to touch or movement of their knees or ankles. I have seen 2 year olds, once very active runners and climbers, suddenly revert to crawling or stop moving altogether because of the pain in their joints.

Not all joints with JIA start off swollen or inflamed. Sometimes joints can be slowly under attack and an adolescent may present with persistent joint aches and pain that doesn’t resolve with time. Diagnosis in these cases can be difficult and referral to a paediatric rheumatologist as soon as possible if this is suspected can mean the right treatment can begin with reduction in damage to affected joints. This is usually a combination of medication plus physiotherapy to reduce pain, keep muscles strong, joints mobile and modifying activities to protect joints while they heal.

Some children may have only a few episodes or ” flare-ups” and never have another. However about 60% of children go on to have chronic JIA with joints affected at varying times across their lifetime.  This can be tough for kids, dealing with not being able to join in with their friends playing sport or in the play ground or having to sit out during P.E. lessons at school. It may also affect their social life too – trouble walking around the mall, managing steps up to the movies or bike riding with mates.

JIA is often called the invisible disease, as it’s not always obvious a joint is painful. Chronic pain is debilitating psychologically for kids and their families and they need support and understanding in dealing with this disease.

Next time you drive past a school remember there will be a child in there coping with Juvenile Arthritis.

 

Jan Redman

Paediatric Physiotherapist.

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