Introduction

While none of these signs and symptoms point definitely to juvenile rheumatoid arthritis, all warrant a visit to your child’s health care provider.

• Joint pain, swelling, or stiffness that is not due to an injury and lasts more than a few days
• Loss or limitation of the function of a joint or limb
• Eye irritation, redness, sensitivity to light, or pain
• Any loss of vision, even a slight loss
• Fevers that come and go without explanation
• Rash that comes and goes without explanation
• Lymph node swelling with no apparent illness, lasting more than a few days

Self-Care at Home

Self-treatment is not encouraged in JRA. Without appropriate inflammation-stopping medical treatment, the inflammation in JRA progresses and becomes worse, increasing the risk of permanent damage to joints, eyes, and other body systems. You can take steps at home, however, to improve your child’s comfort and decrease his or her chance of becoming disabled with JRA.

• Encourage your child to be as active as possible. Bed rest is not part of the treatment of JRA except for children with severe systemic disease. Indeed, the more active the child, the better the long-term outlook. Swimming and water aerobics are ideal activities because they place no stress on the joints. Children may experience pain during routine physical activities and thus must be allowed to limit their own activities, particularly during physical education classes. A consistent physical therapy program, with attention to stretching exercises, pain avoidance, joint protection, and home exercises, can help ensure that a child with JRA is as active as possible.
• Make sure your child is eating enough to maintain a healthy weight. Some children with JRA have little appetite. They need to be encouraged to eat enough calories to maintain a healthy weight and a proper energy level. A BalancedDiet that provides all required vitamins and minerals is essential. Give your child at least 3 servings of calcium-rich foods each day. While there is no evidence that this actually improves JRA, it does help keep bones strong and flexible. Make sure your child also gets enough magnesium and vitamin D to help keep bones healthy. Ask your child’s health care provider for information about diet and nutrition for your child. He or she can refer you to a dietitian if necessary.
• Help your child learn techniques for dealing with the discomfort and pain of JRA. In many cases, combining pain-relieving medication (analgesics) with other techniques gives the best balance of pain relief with fewest unwanted side effects. Techniques such as biofeedback, progressive muscle relaxation, meditation, deep breathing, and guided imagery can help children overcome pain. Hot baths or showers, a warm bed, range-of-motion exercises, and hot packs can relieve morning stiffness. Some children respond better to cold packs than to warmth. A plastic bag of frozen vegetables makes a great ice pack.

Prevention

We do not know how to prevent JRA. Following recommended treatment is the best way to prevent worsening of the disease. If left untreated, JRA will continue to worsen and eventually can lead to joint damage and disability, and possibly other serious complications.