Juvenile Rheumatoid Arthritis. Part 2

Treatment and Management
Because there are so many techniques for treating JRA, the ideal approach is team care. Here, specialists work together, and with the family, to implement a multifaceted treatment plan of medication and rehabilitation therapy.

Medication
The choice of medications depends on the type and severity of the arthritis. The mainstay of initial therapy is usually nonsteroidal anti-inflammatory drugs (NSAIDs). These control pain and inflammation.

In addition, disease modifying antirheumatic drugs (DMARDs) may be used. The proven effectiveness of these new drugs makes the prognosis for JRA better than ever. Used early, often with prednisone, DMARDs can reduce joint swelling, pain and stiffness. More importantly, they may slow, or even halt, irreparable joint and cartilage damage. Before DMARDs, many children failed to respond to treatment; now, they have hope.

Physical Management
While medication relieves pain and inflammation, therapeutic exercise keeps joints functional and builds muscle. As muscles strengthen and stabilize, they protect fragile joints.

During JRA, pain and pressure cause the muscles around a joint to spasm and tighten. When this happens, the child tends to stay in the most comfortable position, usually with the joint bent. If she holds the position too long, muscles and tendons shorten, grow improperly and the joint stays permanently bent.

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