Juvenile idiopathic arthritis (JIA), also sometimes called juvenile rheumatoid arthritis, is a chronic autoimmune disease. JIA causes inflammation in one or more joints in children under the age of 16. Autoimmune diseases happen when the body’s immune system, instead of fighting against infections, mistakenly attacks healthy tissue. In JIA, the immune system targets the lining of the joints, causing swelling, pain and stiffness. JIA is an umbrella term that encompasses several subtypes with varying characteristics. The main types of JIA include:

• Oligoarthritis
• Polyarthritis
• Systemic JIA (Still’s disease)
• Enthesitis-related arthritis (ERA)
• Psoriatic arthritis
• Undifferentiated arthritis

Juvenile idiopathic arthritis affects an estimated 300,000 children in the U.S. and is slightly more common in girls than boys. 

Symptoms of juvenile idiopathic arthritis

JIA symptoms can vary depending on the type and severity of the condition. Some of the most common symptoms to watch for include:

• Joint pain, swelling, stiffness and tenderness
• Joint stiffness in the morning
• Limping
• Fatigue
• Fever, rash and swollen lymph nodes
• Decreased appetite and weight loss
• Eye problems

Risk factors for juvenile idiopathic arthritis

Unfortunately, the exact cause of JIA is unknown. However, it may be due to a combination of factors that can include:

• Genetics
• Immune system dysregulation
• Inflammatory processes
• Infections
• Toxin exposure
• Coexisting autoimmune diseases

Treatment options for juvenile idiopathic arthritis

There currently is no cure for JIA, but there are a variety of treatments available to help manage symptoms, improve joint function and potentially slow disease progression. The specific treatment plan will depend on the type and severity of the child’s JIA. Here are some common treatment options:

• Medications — Medications like nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can help reduce pain, swelling and inflammation. In some cases, stronger medications called disease-modifying antirheumatic drugs (DMARDs) or biologic therapies may be used to help suppress the overactive immune system. Your child’s doctor may also prescribe injection or oral corticosteroids to provide temporary, short-term relief during a flare-up of JIA. 
• Physical therapy — Physical therapy can play a crucial role in your child’s JIA treatment. A physical therapist can help your child maintain joint flexibility, strength and range of motion. They can also teach them exercises to help improve their posture and walking pattern.
• Occupational therapy — Occupational therapy can help your child develop the skills they need to do daily activities despite the limitations caused by JIA. This may include learning how to use adaptive equipment, managing pain while doing tasks and developing coping strategies.

Physical therapy treatments for juvenile idiopathic arthritis

Physical therapy can be a vital part of helping to manage your child’s JIA symptoms and improving their quality of life. Here’s a breakdown of some key techniques that can be used in physical therapy for JIA and how they can benefit your child:

• Therapeutic exercises — Therapeutic exercise is a broad category that encompasses exercises designed to help improve range of motion, strengthen muscles, and enhance balance, coordination and the body’s awareness. For example, exercises may involve gentle stretches to help improve flexibility in affected joints. These stretches can be followed by targeted strengthening exercises for the surrounding muscles. Activities that involve hopping on one leg or walking on a balance beam can help improve their body’s awareness and stability, which can help reduce their risk of falls. 
• Manual therapy — Manual therapy is a hands-on approach that involves a variety of techniques specifically designed to help improve joint mobility, reduce pain and stiffness, and promote relaxation in the muscles surrounding the affected joints. Manual therapy includes techniques like:
• Soft tissue mobilization — Soft tissue mobilization is a technique that involves your child’s physical therapist using their hands to apply gentle pressure and strokes to tight muscles, tendons and ligaments around the joints. This technique can help improve your child’s flexibility, reduce their pain and inflammation, and boost circulation. This can lead to better range of motion and decreased stiffness in the affected joints. 
• Joint mobilization — Your child’s physical therapist will use specific manual techniques to gently move the joints through their range of motion. Joint mobilization can help improve flexibility, reduce stiffness and prevent joint contractures. Joint contractures are the permanent shortening of muscles and tendons that can limit movement in the affected joint. This technique can also help improve joint lubrication and reduce pain. 
• Custom orthotics — In some cases, custom orthotics can be beneficial for children with JIA. Custom orthotics are shoe inserts, created based on impressions of your child’s feet, designed to support and correct specific foot and ankle problems. Orthotics can help improve alignment, reduce pain and prevent further joint damage.
• Home exercise programs — A crucial part of physical therapy is empowering you and your child to manage their JIA at home. Your child’s physical therapist will develop a personalized home exercise program that incorporates stretches, strengthening exercises and activities that your child can do regularly to help maintain progress and manage symptoms between clinic visits. 
• Aquatic therapy — Exercises done in the water can be especially beneficial for children with JIA. The buoyancy of water can help reduce stress on joints while allowing for a wider range of motion. Aquatic therapy can be a fun and effective way to help your child improve flexibility, strength and cardiovascular health with minimal impact.
• Electrical stimulation — In some cases, your child’s physical therapist may use electrical stimulation to help reduce pain and muscle spasms. Low-level electrical currents are delivered through small electrodes applied to the skin around the affected area. These currents can help improve circulation, reduce pain signals and promote muscle relaxation.
• Balance and gait training — JIA can sometimes affect balance and coordination. Your child’s physical therapist can assess their walking pattern (gait) and develop exercises that can help improve their balance and stability. This can help prevent falls and improve their overall confidence and mobility.

By incorporating a variety of these techniques, physical therapy can play a significant role in helping your child manage JIA symptoms, improve joint function and live an active life.

Occupational therapy for juvenile idiopathic arthritis

Occupational therapy can be another key component of a comprehensive JIA treatment plan. Occupational therapists focus on helping children with JIA develop the skills they need to do everyday tasks and activities despite limitations caused by their disease. This can significantly improve their independence and overall well-being. 

Here are some specific ways occupational therapists can help children with JIA:

• Adaptive equipment — Your child’s occupational therapist can assess their needs and recommend adaptive equipment that can make activities of daily living easier. These may include equipment such as:
• Grab bars in the bathroom
• Raised toilet seats
• Splints to support joints
• Specialized utensils for eating
• Activity modification — Your child’s occupational therapist can help them learn how to modify everyday activities to help minimize stress on their joints. For example, they may recommend using a backpack with wider straps or learning how to open jars with one hand. 
• Energy conservation techniques — JIA can cause fatigue. Occupational therapy can help your child learn how to use conservation techniques, like pacing themselves throughout the day or prioritizing tasks, and develop routines that can minimize fatigue-inducing activities. 
• Pain management strategies — Similar to physical therapists, occupational therapists can teach your child how to manage their pain with strategies like relaxation techniques and splinting to help them cope with pain during daily activities.
• Fine motor skills development — An occupational therapist can help your child develop exercises and strategies to improve fine motor skills that can sometimes be impacted by JIA. Fine motor skills are the small movements of the hands and fingers that are needed for tasks like:
• Writing
• Buttoning clothes
• Tying shoelaces

Treatment for JIA can vary depending on a child’s needs and severity of their condition. Approaches like physical therapy and occupational therapy can help maximize your child’s ability to manage symptoms, maintain joint health, and live a full and active life. 

Find help for juvenile idiopathic arthritis at Excel Rehab & Sports

 

At Excel Rehab & Sports, we understand the challenges living with JIA can present for your child. We believe with the right support and comprehensive care, children with JIA can thrive. Our expert and compassionate team includes physical therapists and occupational therapists. They can create a personalized plan to address both physical limitations and emotional well-being. Our collaborative approach can help ensure that your child will always receive the best possible care. 

Call us or request an appointment today to learn more about our physical therapy and occupational therapy treatments for juvenile idiopathic arthritis.