What is juvenile idiopathic arthritis (JIA)?
Juvenile idiopathic arthritis (JIA) is the most common type of chronic, or long-lasting, arthritis that affects children. It happens when the immune system attacks healthy joint tissues.
JIA broadly refers to several different chronic (long-lasting) disorders involving inflammation of joints (arthritis), which can cause:
- Joint pain.
- Loss of motion.
JIA may last a few months or years, or it may be a lifelong disease.
Who gets juvenile idiopathic arthritis (JIA)?
JIA begins in children and adolescents before they turn 16. Most types of the disease are more frequent in girls, but others affect boys more frequently or affect boys and girls equally. Children of all races and ethnic backgrounds can get the disease.
Though JIA does not tend to run in families, children with a family member who has long-lasting arthritis, including JIA, are at a slightly increased risk of developing it.
What are the types of juvenile idiopathic arthritis (JIA)?
There are multiple types of JIA, each with different features. Generally, they all share symptoms of joint pain, swelling, warmth, and stiffness that last at least 6 weeks.
What are the symptoms of juvenile idiopathic arthritis (JIA)?
Symptoms of JIA vary depending on the type, but all forms share persistent joint pain, swelling, warmth, and stiffness that are typically worse in the morning and after a nap or prolonged sitting.
Many children, especially younger ones, will not complain of pain. One of the earliest signs may be limping in the morning due to disease in one or both legs.
The symptoms of JIA may get worse (flares) for a few weeks or months, followed by times when they get better. Some children have just one or two flares and never have symptoms again, while others have many flares or symptoms that never fully go away.
Besides joint problems, the inflammation associated with JIA can cause other symptoms, such as:
- Eye inflammation. It is important for children with JIA to have frequent eye exams because this inflammation can lead to eye problems and vision loss.
- Skin changes, such as rashes.
- Growth problems.
What causes juvenile idiopathic arthritis (JIA)?
In JIA, the body’s immune system—which normally helps to fight off infections and heal cuts and wounds—mistakenly attacks some of its own healthy cells and tissues. The result is inflammation, causing pain, swelling, warmth, and stiffness.
Doctors do not know why the immune system attacks healthy tissues in children with JIA, but they believe that a mix of genes and environmental factors are involved.
Is there a test for juvenile idiopathic arthritis (JIA)?
There is no single test that doctors can use to see if your child has JIA. Doctors may:
- Take your child’s medical history and do a physical exam.
- Order lab tests.
- Order imaging tests, such as x-rays, ultrasounds, or magnetic resonance imaging (MRI).
How is juvenile idiopathic arthritis (JIA) treated?
Most children with JIA need a mix of medicines and a healthy lifestyle, including a balanced diet and exercise, to reach treatment goals, which may include:
- Control inflammation.
- Reduce pain and stiffness.
- Prevent joint and organ damage.
- Improve joint function.
- Promote physical and psychosocial growth and development.
- Achieve remission (little or no disease activity or symptoms).
- Allow for full engagement with normal activities (e.g., school, work, sports, social life, family life).
Treatment may include:
- Medications, to relieve pain and swelling and slow joint damage.
- Physical therapy to:
- Relieve pain.
- Help affected joints move better.
- Strengthen muscles.
- Prevent injury from sports or other physical activities.
- Regular medical care to see how treatment is working and adjust it as needed.
Who treats juvenile idiopathic arthritis (JIA)?
Usually, several different health care providers treat JIA. JIA is primarily treated by:
- Pediatric rheumatologists, who specialize in treating arthritis and other diseases in children that involve the joints, bones, muscles, and immune system.
Other members of your child’s health care team may include:
- Mental health professionals, who can help children cope with difficulties in the home and at school that may result from their medical condition.
- Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
- Ophthalmologists, who diagnose and treat diseases of the eyes.
- Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.
- Pediatricians, who provide routine medical care for children.
- Physical therapists, who help to improve joint function.
- Rheumatology nurses, who may serve as the main point of contact with your doctor’s office about appointments, tests, medications, and instructions.
- Social workers, who can help your child and your family deal with lifestyle changes caused by arthritis. A social worker can help you find resources and can help you work with your child’s school to address any issues.
Living with juvenile idiopathic arthritis (JIA)
JIA can make it difficult for your child to take part in social and after-school activities and to do schoolwork. However, it is important to treat your child as normally as possible.
You can help your child to function on their own and keep a positive outlook by doing the following.
- Manage medical care by:
- Ensuring that your child receives appropriate medical care and that you and your child follow the doctor’s instructions.
- Learning as much as you can about JIA and its treatment.
- Keeping a record of your child’s symptoms and side effects of medications.
- Balance rest and exercise. Your child should have more rest when JIA is active and more exercise when it is not. In general, shorter rest breaks every now and then are more helpful than long times spent in bed. Talk to your child’s health care provider before beginning an exercise program.
- Care for the joints by:
- Using cold packs to help ease swelling and numb painful joints
- Using heat treatments, such as hot showers or heating pads, for stiff joints and muscles.
- Wearing a splint (a piece of hard material, usually wrapped in fabric) for a short time around a painful joint to reduce pain and swelling. Talk to your child’s doctor before using a splint.
- Work with your child’s school to create a plan that supports your child throughout the school year.
- Encourage a healthy diet, which is important for overall health.
- Help your child cope with stress. Ideas include:
- Doing relaxation, distraction, or visualization exercises.
- Being physically active.
- Seeing a mental health professional.
- Joining a support group for children with JIA.