Many conditions bring parents to our office concerned for the health of their children.  A full twenty percent of our practice consists of pediatrics.   We see a plethora of ailments from sports injuries to scoliosis, but the most difficult to treat are chronic arthropathies including juvenile rheumatoid arthritis.  This condition can be difficult to manage in the sense that it is hard to imagine the lives of children who are suffering.  Just like anything else, however, it helps to be aware of the facts involved.  Early intervention can make a world of difference in the amount of suffering a child must endure.  While chiropractic can certainly help ease the pain of juvenile rheumatoid arthritis, it cannot cure it.  Nothing can.  Presently there is active research by the Arthritis Foundation and many other groups who are trying to find an answer to this sometimes crippling nuisance.

Juvenile rheumatoid arthritis (JRA) is the most common form of arthritis found in children.  The cause is not completely understood, and there is no one definitive test for the disease.  If a child under the age of 16 has joint pain and inflammation which lasts for more than six weeks, JRA is immediately suspected.  A pediatrician might perform certain blood tests to rule out other conditions then refer the child to a rheumatologist (doctor who specializes in joint disorders) for further evaluation.

JRA is thought to be an autoimmune disorder.  Autoimmune disorders are those in which the body for some unknown reason attacks its own cells and tissues.  In the case of JRA, the joint capsules and soft tissues around them are the targets of the errant attacks.  This results in painful, warm joints at best and disfigured ones at worst.  Although most researchers agree that JRA is an autoimmune disorder, genetics and environmental factors are also thought to play roles in the occurrence of the disease.  Some genetic markers are present that can be tested for, but they are not necessarily specific for JRA.  Some people with the markers will not develop JRA while some others without it will.  Research is still ongoing for better ways to detect the disease.

There are some serious complications that can result from the incidence of JRA.  They include eye inflammation that, if left untreated, can lead to glaucoma, cataracts, calcium buildup in the cornea, and ultimately, blindness.  It is recommended that patients with JRA be seen by an ophthalmologist at least every six months and in some cases every three months.  These regular visits can avoid some types of eye disorders that might occur without any early symptoms.  JRA has also been known to inhibit proper bone growth and development.  Many doctors choose to treat JRA with corticosteroids to battle chronic inflammation.  Corticosteroids such as prednisone can interfere with normal growth and development and increase a child’s susceptibility to infections.  These drugs are used mainly in the more severe cases, and their usefulness and risks should be heavily considered by parents whose children are advised to take them.  In many cases, pain relievers and non-steroidal anti-inflammatory drugs are all that are required to keep the pain at bay.  Sometimes a drug known as a disease-modifying antirheumatic drug is used if the NSAIDs alone are ineffective.  These drugs are used in conjunction with NSAIDs to slow the progression of JRA.

Also important in the management of JRA is the restoration of motion that has been lost in joints.  There are many ways to achieve this, including exercise, physical therapy, and chiropractic manipulative treatment.  If a joint has lost its mobility, it is important to restore it in order to avoid degeneration.  There is no substitute for motion, and it is vital for all of our joints.  It is essential for children with JRA to remain as active as possible to maintain flexibility and build strong muscles.  Swimming is an excellent way to exercise the joints since it alleviates stress on joints while it encourages flexibility and builds muscles. Chiropractors and physical therapists can be of enormous help in managing the pain and restoring the lost motion of JRA.

Helen Keller was once quoted as saying, “Although the world is full of suffering, it is also full of the overcoming of it.”  A diagnosis of JRA is not the end of the world.  A child is not necessarily doomed to a steady diet of harmful medications that retard his growth and development.  Proactive parents who get involved with overcoming the suffering of their ailing children are guardian angels in disguise.  Treat your body and your spirit well.