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The special expertise of rheumatologists in caring for patients with JRA is extremely valuable. Pediatric rheumatologists are trained in both pediatrics and rheumatology and are best equipped to deal with the complex problems of children with arthritis and other rheumatic diseases. However, there are very few such specialists, and some areas of the country have none at all. In such circumstances, a team approach involving the child's pediatrician and a rheumatologist with experience in both adult and pediatric rheumatic disease provides optimal care for children with arthritis. Other important members of the team include physical therapists and occupational therapists.
The main goals of treatment are to preserve a high level of physical and social functioning and maintain a good quality of life. To achieve these goals, doctors recommend treatments to reduce swelling; maintain full movement in the affected joints; relieve pain; and identify, treat, and prevent complications. Most children with JRA need medication and physical therapy to reach these goals.
Several types of medications are available to treat Juvenile Rheumatoid Arthritis
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Disease-modifying anti-rheumatic drugs (DMARDs)
If NSAIDs do not relieve symptoms of JRA, the doctor is likely to prescribe this type of medication.
- Corticosteroids
In children with very severe JRA, stronger medicines may be needed to stop serious symptoms such as inflammation of the sac around the heart (pericarditis)
- Biologic agents
Children with polyarticular JRA who have gotten little relief from other drugs may be given one of a new class of drug treatments called "biologic agents."
- Physical therapy
Exercise is an important part of a child's treatment plan. It can help to maintain muscle tone and preserve and recover the range of motion of the joints. A physiatrist (rehabilitation specialist) or a physical therapist can design an appropriate exercise program for a person with JRA. The specialist also may recommend using splints and other devices to help maintain normal bone and joint growth.
- Complementary and alternative medicine
Many adults seek alternative ways of treating arthritis, such as special diets or supplements. Although these methods may not be harmful in and of themselves, no research to date shows that they help.
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