Small People, Big Pain

Juvenile Arthritis Awareness

/ Author:  / Reviewed by: Joseph V. Madia, MD

Even though most of us think that arthritis is a problem that only affects older people, adults are not the only ones who get arthritis. Kids can suffer from the disease too.

It can come as a shock for any parent to hear that their child has arthritis, or juvenile arthritis as it is often called. In order to make an arthritis diagnosis easier on children and their families, the Arthritis Foundation is recognizing Juvenile Arthritis Awareness.

Why Should We Be Aware of Juvenile Arthritis?

Most people think that arthritis is a disease that only adults can get. It is understandable to have this assumption, as many people get arthritis after many years of wear and tear on their joints. However, arthritis can happen for quite a few other reasons, including broken bones, infections, and autoimmune disease (when the body's immune system attacks healthy tissue by mistake).

Because arthritis can be caused by so many factors, children can also get the disease. In fact, nearly 300,000 children under the age of 18 are are living with arthritis and other similar conditions.

In other words, juvenile arthritis is not uncommon. Yet many parents may not know how to react when they hear that their child has this painful disease.

The Arthritis Foundation uses Juvenile Arthritis Awareness month to reach out to the children and families trying to deal with this disease. Children will find it easier to live with juvenile arthritis is they and their families learn more about the disease and how to treat it.

What is Juvenile Arthritis?

Juvenile arthritis is not one specific disease. Rather, juvenile arthritis is a term used to describe a wide array of autoimmune and inflammatory conditions that can affect children 16 years old and younger.

In general, arthritis is the inflammation of people's joints, or the area where two bones meet. Juvenile arthritis can also affect the eyes, skin, and gastrointestinal tract.

There are several different types of juvenile arthritis. The most common form of the disease is juvenile idiopathic arthritis, which used to be called juvenile rheumatoid arthritis. In this form of the disease, a child younger than 16 years of age has had swelling in at least one joint for six weeks or more.

Children suffering from juvenile idiopathic arthritis may have a range of symptoms that include the tightening of muscle or soft tissue, the wearing away of bone, joint misalignment, and changes to their growth patterns.

Being diagnosed with juvenile idiopathic arthritis is only the beginning for a young patient. After the first diagnosis, a pediatric rheumatologist (or arthritis doctor for children) has to figure out which type of juvenile idiopathic arthritis a child has. The doctor will do this by keeping track of the number of joints affected by the disease during the first six months. The doctor will also give patients the rheumatoid factor blood test - a test that looks in patients' blood for a substance usually found in people with the disease.

Eventually, a doctor should be able to diagnose a child with one of a number of types of juvenile idiopathic arthritis, including:

  • Oligoarthritis: Patients are diagnosed with this type of arthritis if they have four or less joints affected by the disease within the first six months. Oligoarthritis accounts for 40 percent of new cases of juvenile idiopathic arthritis.
  • Polyarthritis: Children diagnosed with polyarthritis have five or more joints affected by the disease within the first six months.
  • Systemic: Even though only about 10 percent of juvenile idiopathic arthritis cases are systemic, this form of the disease can affect the whole body. Patients can come down with a fever and rash, while inflammation can affect the spleen or the membranes that cover the lungs and heart.
  • Enthesitis-related: This type of juvenile idiopathic arthritis happens when inflammation affects the enthuses, or the spots where tendons attach to the bone.
  • Other forms of juvenile arthritis: Even though juvenile idiopathic arthritis is the most common type of juvenile arthritis, children can be diagnosed with many other forms of the disease, including juvenile lupus, juvenile scleroderma, juvenile psoriatic arthritis, and juvenile dermatomyositis.

Who Suffers from Juvenile Arthritis?

Juvenile arthritis is rather mysterious. No one really knows what causes each form of the disease. However, some studies have found links between children's genes and their risk of juvenile arthritis.

Girls are more likely than boys to get oligoarthritis and polyarthritis. Boys, on the other hand, are more likely to get enthesitis-related arthritis. Boys are just as likely as girls to be diagnosed with systemic arthritis.

While boys may be more at risk than girls, and girls more at risk than boys, for certain types of juvenile arthritis, the Arthritis Foundation reminds us that there are always exceptions to the rule. Working with your child's doctor is the best way to get a correct and fast diagnosis.

Even though blood tests are used in the diagnosis of juvenile arthritis, they tell little about the disease. The best way to diagnose arthritis is through a thorough physical exam and understanding of a child's medical history. Blood tests, meanwhile, can be used to rule out other possible causes of arthritis symptoms, such as infection.

How Can You Treat Juvenile Arthritis?

Sadly, there is no cure for juvenile arthritis. However, there are important steps that children and their families can take to make it easier to live with the disease.

One major step is to get a correct diagnosis. Even if the diagnostic process is lengthy and stressful, it will help in the long-run. Once a child has the right diagnosis, dealing with juvenile arthritis usually involves drug treatment, physical activity, eye care, and a healthy diet. The goal of treatment is to reduce inflammation, relieve pain, and make a child's quality of life better.

Meds for Juvenile Arthritis

Juvenile arthritis is treated with two different types of drugs. The first type is used to reduce pain and inflammation. These drugs include nonsteroidal anti-inflammatory drugs (e.g. Celebrex, Anaprox, Motrin), corticosteroids, and analgesics.

The second type of drug is used to change the course of the disease, stop it from getting worse, and to keep joints from getting damaged. This type of drug are called disease-modifying antirheumatic drugs and biologic response modifiers (biologics). They include Plaquenil (hydroxycholoroquine), Arava (leflunomide), and Humira (biologics) among others.

Just as every child is different, every child will respond differently to different drugs. Do not be alarmed if your child's doctor tries out several drugs before choosing the one that is best for your child.

Extra Support

Children with arthritis may be given splints to help keep their joints in the right place and to lower pain. They may also be given shoe inserts to make up for different leg lengths or to make their balance better.


Juvenile arthritis patients also get great benefits from physical and occupational therapy. Physical therapists guide arthritis patients through light exercises that keep joints loose while also strengthening muscles and building endurance.

Occupational therapists will teach kids how to do day-to-day tasks without making their arthritis symptoms worse. Occupational therapy can make a children's quality of life improve by showing them how to bathe, get dressed, or wear a backpack without experiencing pain.

Healthy Living

One of the most important parts of fighting arthritis is having a healthy lifestyle and a healthy body. A child with juvenile arthritis should regularly get moderate exercise. Getting up and moving around keeps joints flexible and strong. Exercise may be painful for a child, but it is necessary for treatment to work well. Some physical activities that are easy on the joints of juvenile arthritis patients include swimming, walking, and biking.

Some children made need to lose weight in order to relieve some of the stress on their joints. Other children made need to gain weight because they have not eaten enough food because of jaw pain or fatigue. Gaining weight might involve eating a high calorie diet with lots of nutrients. Losing weight might involve working with a dietitian to develop a healthy diet for a child with arthritis.

Going Under the Knife

Even though it is rare, surgery may be something that a doctor recommends to a child with arthritis. Surgery can be used to lower pain, to put a bent or deformed joint back in the right place, or to replace a damaged joint.

Eyes and Teeth

Juvenile arthritis can affect more than a child's joints. The disease is also related to eye and dental problems. Some juvenile arthritis patients may suffer from uveitis (inflammation inside the eye) and iritis (inflammation of the iris). It is important that children with arthritis get regular eye exams in order to stop any eye problems from developing.

Children with arthritis may also have trouble opening their jaw widely enough to get their teeth clean. Dentists can give these children tools that help with brushing and flossing. Occupational therapists can also help children learn to move their jaw better.

What is it like to live with Juvenile Arthritis?

Children with arthritis will have to deal with all sorts of emotional issues. It is important that parents prepare their child for the emotional strain that may happen from arthritis. Children should know that they may get sad or angry that they have arthritis, and then they should learn to cope with these emotions. Children should realize that arthritis is only part of their life, not their entire life.

Having juvenile arthritis not only affects the child with the disease, but also that child's family. Some parents may feel sad, guilty, or angry that their child has arthritis. Other parents may want to keep quiet about their child's disease, but the best thing for a parent to do is to keep regular schedules and relationships. Consistency is important for teaching children to live as normally as possibly with their disease.

Even if children have arthritis, it is important that they go to school just as often as any healthy student. Parents may need to save some extra time in the morning to get their child's joints loose before going to school.

Eventually, a child will get old enough to start taking care of her own care. As a child gets older, she should start learning everything she can about her drugs and their side effects, and how to keep track of arthritis symptoms. A child will have to learn how to communicate her feelings to a doctor without the help of a parent.

Once an arthritis patient reaches adulthood, she will have to know how to continue living an active and productive life without the constant help of parents. The earlier a child learns to deal with arthritis on her own, the easier the transition into adulthood will be.

Review Date: 
July 19, 2011