Juvenile Arthritis

JUVENILE IDIOPATHIC ARTHRITIS

Arthritis is not just a disease of the elderly. Childhood arthritis or juvenile idiopathic arthritis (JIA) affects one of every 1000 Canadian children under the age of 16. It is among the most common chronic childhood disorders. In some children, it can last for as little as several months to a year and then disappear forever, while others will experience an upand-down course of their JIA (flare-up and remissions) for many years.

JIA is an autoimmune disease (one in which the body fights itself) that causes continuous inflammation of the one or more joints lasting at least six weeks for which no other cause can be found. The inflammation results in stiffness, swelling and pain. The exact cause of JIA is unknown.

Although there currently isn’t a cure for JIA, there is effective therapy. With proper management most children with this disease lead healthy active lives and enter adulthood without any major physical disability. In some forms of the disease, children can go into complete remission as they grow into adulthood.

The treatment approach for JIA emphasizes the involvement of a multidisciplinary healthcare team, including a family physician, rheumatologist, social worker, psychiatrist, dietitian, occupational therapist and physiotherapist. Drugs, such as non-steroidal antiinflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs), steroids, and the recently emerged biologics, have a major role in controlling inflammation and the disease process that occurs in JIA. Rehabilitation treatment, such as, physiotherapy has an important adjunctive role in the management of JIA. Physiotherapy aims to prevent physical impairment and restore functional ability through education and exercise.

TALK TO A PHYSIOTHERAPIST

A physiotherapist is an important member of your child’s multidisciplinary
healthcare team. A physiotherapist will work with you and your child to reduce
pain; restore mobility, function, strength and flexibility; prevent unnecessary disability; and help your family cope with JIA in everyday life.

Reducing Pain

Physiotherapists can help reduce pain caused by JIA:

  • With specific therapeutic modalities;
  • By recommending the use of assistive devices, such as splints; and
  • Prescribing a proper exercise program that will maintain function of joints and decrease pain in joints by strengthening the muscles surrounding them.

Exercise Program

  • If your child has JIA it is very important that he/she exercises. Exercise can help reduce pain and prevent further joint damage;
  • Stretching and strengthening exercises can help reduce pain, prevent loss of joint movement and support the joint;
  • Generally speaking, low impact activities, such as riding a bike and swimming, are also recommended.

Coping with Juvenile Idiopathic Arthritis

A physiotherapist will:

  • Help your child with specific challenges, such as climbing stairs and balance, and may recommend splinting to hold the child’s joints in a good position at night or when resting, or to relieve pain during normal daytime activities;
  • Teach you ways to help your child avoid stiffness (i.e. the right way to lie in bed) and the importance of balancing rest with activity; and
  • Facilitate an optimal activity program best suited to your child’s needs

Physiotherapists are university trained healthcare professionals who help people of all ages and lifestyles gain and maintain their desired level of active living and physical functioning. With their applied knowledge and
understanding of the human body in action, physiotherapists are able to help you to increase mobility, relieve pain, build strength and improve balance and cardiovascular function. Physiotherapists not only treat injuries, they also teach you how to prevent the onset of pain or injury that can limit your activity.

How do I find a physiotherapist?

Finding a physiotherapist may vary from province to province. Here are some suggestions:

  • Check the yellow pages of your local telephone book for listings of physiotherapists and physiotherapy clinics. You can make an appointment with a physiotherapist directly anywhere in Canada.
  • Ask for a recommendation from your family doctor. While a direct referral is not necessary, your physician may be able to suggest a physiotherapist for your particular concern. Further, while many physiotherapy services are covered by provincial health care plans, Workers Compensation plans and private insurance, some insurance plans require a doctor’s referral for reimbursement.
  • Visit the web site of the Canadian Physiotherapy Association at www.physiotherapy.ca to access our “Find A Physiotherapist” directory and to find out more information about physiotherapy. The CPA web site can also link you to resources for finding physiotherapists through provincial association branches and regulatory colleges.