What Is Arthritis?

You may have heard about arthritis (say: ar-thry-tis), which is a disease that causes swelling and pain in a person's joints.

But isn't it something that only old people get?

Actually, kids can get a kind of arthritis called juvenile idiopathic arthritis or JIA (it's also called juvenile rheumatoid arthritis, or JRA). Juvenile means young, so this means that JIA is different from the arthritis that adults get. Kids can have many different types of arthritis, but this is the most common.

Joints are the places where bones meet. Arthritis can prevent people from moving their joints properly. JIA affects kids under age 16, who have arthritis in one or more joints.

Many problems can cause pain and swelling of the joints, so a doctor will want to know how long these problems have been going on. To be considered JIA, a kid must have swelling and pain for at least 6 weeks.

Seven Kinds of JIA

Seven types of juvenile idiopathic arthritis can affect kids:

1. systemic
2. oligoarticular (say: aw-lih-go-ar-tik-yoo-lur)
3. polyarticular (say: pah-lee-ar-tik-yoo-lur), rheumatoid factor negative
4. polyarticular (say: pah-lee-ar-tik-yoo-lur), rheumatoid factor positive
5. psoriatic (say: soar-ee-ah-tik)
6. enthesitis-related (say: en-theh-sye-tiss)
7. undifferentiated

Why Do Kids Get It?

No one really knows what causes JIA. Something in the environment such as a virus may trigger the disease in kids that already have certain genes that make it more likely for them to get it. JIA is not contagious, so you can't catch it from someone else.

Arthritis is an autoimmune (say: aw-toe-i-myoon) disease. Normally, a kid's immune system sends out white blood cells to protect the body and fight outside invaders like bacteria and viruses that can make a kid sick. With JIA, the immune system makes a mistake and targets healthy cells as if they were harmful.

Instead of recognizing the healthy cells and saying, "Hi, nice to see you," the immune system thinks the healthy cells need to be destroyed and releases chemicals to fight the healthy cells. The chemicals the immune system releases cause the pain and swelling that a kid with arthritis experiences.

What Do Doctors Do?

Just because a joint hurts doesn't mean a kid has JIA. A joint might hurt for a lot of different reasons, which is why it's important to see a doctor to figure out what the problem is.

The doctor will ask a lot of questions: How long has the kid had joint problems? Does he or she feel stiff when getting up or after resting? Are the joints swollen? Was there an injury? Could another problem be causing arthritis, such as Lyme disease? Is there a family history of arthritis or other autoimmune diseases?

Getting these answers and doing a physical exam, blood tests, and X-rays will help the doctor figure out if it is JIA. If your doctor suspects that you may have it, he or she may send you to see a doctor who specializes in the diagnosis and treatment of arthritis. This kind of doctor is called a rheumatologist (say: roo-muh-tol-oh-jist).

How Is It Treated?

Some kids who have JIA might take medicine such as ibuprofen to help control pain and inflammation. If the arthritis is more severe, they may need to take additional medicines to decrease pain and inflammation and to slow the progression of the disease. Some of these medicines are pills, but others are shots.

It is important that kids with JIA keep their joints moving. Often a kid will see a physical therapist or occupational therapist. In addition to working with children to move their joints and strengthen their muscles, these therapists can help create special exercise programs for home or school that can help a kid stay active.

In addition to joint problems, JIA may cause uveitis (say: yoo-vee-eye-tus), an inflammation of the eye that can lead to problems with vision if it's not treated. It's more common in kids with oligoarticular arthritis but all kids diagnosed with JIA should get their eyes checked by an ophthalmologist, a doctor who specializes in diagnosing and treating eye problems. If the eyes are affected, they may be treated with eye drops.

A kid can do a few things to help with the symptoms of JIA besides taking medicines:

• Keeping joints warm and staying active can help maintain mobility.
• Warm baths can make a kid's joints hurt less.
• An electric blanket on a timer that turns on 1 hour before a kid wakes up can help warm the joints so he or she can move better.
• Some kids dip their hands in a special warm wax called paraffin that helps their joints ache less.

Living With Arthritis

Kids with JIA can have a lot of stiffness when they first wake up in the morning. Once their joints warm up, they can usually move more easily. That's why you might notice that someone with JIA has trouble moving early in the day, but seems better later on.

It's important to find a good balance between activity (which helps kids stay flexible) and rest (which everyone needs). Swimming is a great exercise for someone with JIA. It stretches a lot of different muscles and tendons and helps keep a kid moving and flexible. It's important to stay active even when a kid isn't having symptoms.

Sometimes kids with JIA can go a long time, even months or years, without the disease bothering them. Then it comes back. This is called a flare-up or flare. Flare-ups just happen and can't be prevented. It can be frustrating if a flare-up happens on a day when the kid would like to be doing something fun, like attending a birthday party.

If you know someone with JIA, you may offer to carry books or give other help, if needed. It's also OK if the person doesn't want help.

The good news is that many kids with JIA will outgrow it. Kids with oligoarticular JIA generally do better than kids with polyarticular arthritis, but as many as 7 out of 10 kids with polyarticular JIA may not require treatment as adults.

And even when the arthritis is active, almost all kids with JIA can control it with medicine and other treatments, which means they can do most things that other kids can do.

Reviewed by: AnneMarie C. Brescia, MD
Date reviewed: January 2012