What to Know About Arthritis in Children
Juvenile idiopathic arthritis (JIA) is the most common form of arthritis that affects children and adolescents. Like adult rheumatoid arthritis (RA), JIA is characterized by pain and inflammation throughout the body as the result of joint inflammation and stiffness.
In contrast to the ongoing nature of RA, some children do outgrow JIA. However, it can impact a growing child’s bone development, so treatment is important.
Here’s what to know about the causes, symptoms, and treatment options of JIA.
What is juvenile idiopathic arthritis?
Juvenile idiopathic arthritis affects children and adolescents age 16 and under. It may cause joint pain and inflammation anywhere in the body, but most commonly in the hands, knees, ankles, elbows, and wrists.
If untreated, JIA can lead to health complications, including:
- Issues with growth and development
- Bone health issues
- Joint damage
- Eye health issues such as cataracts or glaucoma, as JIA can cause inflammation in the eyes
- More rarely, issues with the kidneys, heart, or endocrine system
The prognosis of JIA varies by individual. About 50% of children and adolescents with the condition fully recover while others continue to experience arthritis symptoms in adulthood.
Causes and risk factors
All forms of arthritis including JIA fall under the umbrella of autoimmune diseases. These conditions occur when the immune system mistakenly attacks healthy cells and tissues. With arthritis, the immune system acts on the lining of your joints.
The causes of JIA aren’t fully known (idiopathic means unknown). Genetics likely play a component. Some evidence suggests that some children have a gene that leads to the development of JIA when activated by external factors such as a virus or bacteria.
Symptoms of juvenile idiopathic arthritis
Symptoms of JIA can vary from one child to another. Some individuals experience flare-ups, or periods when symptoms intensify, while others have a more chronic experience of the condition.
Common symptoms include:
- Pain and inflammation in the joints, most commonly in the hands, knees, ankles, elbows, and wrists. (For many, this symptom frequently occurs in the morning or after sleeping.)
- Warmth or redness in a joint
- Difficulty using one or more joints
- Eye inflammation
- Low appetite and slow weight gain
The process of diagnosing JIA often involves several steps, as symptoms may resemble those of other conditions.
A physical exam is typically the starting point, after which a doctor may recommend one or more of the following blood tests to confirm a diagnosis of JIA:
- Antibody tests such as the antinuclear antibody (ANA) test, which measures blood levels of antibodies linked to rheumatic disease
- Tests that check for levels of red and white blood cells and platelets - lower levels of red and white blood cells may be indicative of JIA
- An erythrocyte sedimentation rate (ESR) test, which examines how quickly your red blood cells sink to the bottom of a test tube - higher rates of settlement may indicate inflammation
- A c-reactive protein (CRP) test, which identifies blood levels of CRP, an inflammation-linked protein produced in your liver
- A creatinine test, which checks for kidney disease
- A rheumatoid factor (RF) test, which checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis
Imaging tests such as X-rays, CT scans, MRIs, and bone scans may also be used to support a JIA diagnosis.
Treatment for JIA encompasses medications, lifestyle changes, and physical and occupational therapy, with the goal of reducing symptoms and supporting an active life.
Individual treatment plans depend on a child’s symptoms, age, and overall health history.
The following types of medications may be included in a JIA treatment plan:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®) and naproxen (Aleve®) may be used to reduce pain and inflammation during flare-ups. While these medications are available over the counter, your child may need a prescription for a higher dose.
- Oral corticosteroids such as prednisone may also be used to reduce inflammation in children with JIA.
- Disease-modifying antirheumatic medicines (DMARDs) such as methotrexate (Rheumatrex®) reduce the immune system’s response to triggers, easing inflammation and controlling JIA symptoms.
- Injectable biologic DMARDs — which target more specific pathways in the immune system — are also used in the treatment of JIA, typically after other treatments have proven ineffective. Commonly prescribed biologics include abatacept (Orencia®), adalimumab (Humira®), canakinumab (Ilaris®), etanercept (Enbrel®) and tocilizumab (Actemra®).
Sugars, refined carbohydrates, and gluten can contribute to joint pain and inflammation, so it is often recommended for those with any type of arthritis to reduce their intake of these foods. With JIA, there is the additional consideration of incorporating nutrient-rich foods to support a child’s healthy growth and development. Consider speaking with a nutrition specialist to develop a balanced meal plan.
Regular physical activity is another component of managing JIA. Swimming and other water exercises, yoga, and cycling may be a good fit for children and adolescents with the condition. Physical therapy may be involved in treatment to help a child improve muscle and joint function.
Lastly, it’s important for a child with JIA to get plenty of rest.
JIA is linked to eye inflammation, which can cause more serious eye problems later in life. Staying on track with regular eye exams can prevent and detect potential problems.
Your partner in health
Life with juvenile idiopathic arthritis is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in arthritis treatment and can answer any questions you may have, from medication side effects to navigating lifestyle changes.
In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.
To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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