Sunday, July 21, 2013

Pain Management - Dealing With Systemic Juvenile Rheumatoid Arthritis

As if growing pains were not enough, there is such a thing known as systemic-onset juvenile rheumatoid arthritis which afflicts both girls and boys as they progress from childhood to preadolescence. As a juvenile disorder, it affects children younger than 16 years of age, although there are cases wherein it persists beyond the teens.

What is Systemic JRA?

Think of it as an autoimmune disorder wherein the immune system which normally responds beneficially to fight any infection automatically reacts to combat its own defenses. Even a minor infection which raises the white blood cell count could trigger the autoimmune system of to attack its own body tissues.
Poorly understood, systemic JRA is difficult to diagnose and treat without a series of tests to rule out all other diseases. It can be worrisome because some of its symptoms closely resemble those of leukemia, bone cancer, and other nervous syndromes.

How does it show?

Depending on its severity, the disease is characterized by multiple signs and symptoms such as joint pain, swelling, and stiffness for more than six weeks straight. The child experiences prolonged bouts of high fever and chills which peaks with unexplained measles-like rashes. The experience can be very disheartening and debilitating, which is why pain management should be given importance in systemic JRA.

It is not contagious, because it is neither bacterial nor viral but rather a disease of the immune system. It can be inherited as a third-generation disease, meaning it skips one generation and manifests itself in the next. There is no clear explanation why some children outgrow it completely while others have long symptom-free periods followed by a sudden show of flare-ups.

How do you manage it?

During JRA flare-ups, a child is prone to lose weight and muscle mass which results from lost appetite and limited body movement. On the other hand, prolonged medication and lack of activity would lead to excessive weight gain. Rather than leading a sedentary lifestyle, you could encourage your child to engage in non-strenuous play and sports activities which exercise the joints, bones, and muscles.

As part of pain management care, a child with systemic JRA is attended to by a pediatric rheumatologist. Aside from pain relievers, the usual medications would include NSAIDs and low-dose steroid treatment. The patient may also need specifically-prescribed exercise programs and rehab sessions under the supervision of a physical therapist to completely recover.

How do you deal with it?

When chronic joint pain is recurrent, it goes far beyond what we know of as musculoskeletal pain. The pain is simply indescribable. It could affect the entire body starting from the ankles to the knees, higher to the hips and the shoulders, and even up to the neck and jaws.

As parents of a child with systemic JRA, we only have to deal with it. However, it is our children afflicted with the disease who have to live with it. They will have to cope with its long-term side-effects such as growth delays, accelerated tooth decays and inner eye inflammations which lead to premature scarring and vision problems. With prolonged medication, complications of the heart and liver as well as stomach ulcers are bound to happen.

Aside from our love and patience, we can only lend our children additional support through pain management medications, clinics, and therapies. Keeping informed and updated on current developments in patient care for systemic JRA would help families deal and live with a disease which goes beyond the pains of growing up. Turn to our Fitness Books for more information on pain management and other health matters.

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