Hesperian Health Guides
Managing Juvenile Arthritis
HealthWiki > Disabled Village Children > Chapter 16: Juvenile Arthritis: Chronic Arthritis in Children > Managing Juvenile Arthritis
The child will need:
- medicine to relieve the pain and help prevent damage to the joints
- plenty of rest, keeping the body in good positions
- exercises and movement to prevent contractures and deformities, and to keep the muscles strong
- mental, physical, and social activities, so that the child’s life is full and satisfying
MEDICINE
Ibuprofen is usually the safest and best medicine. It not only helps the pain, but also reduces swelling and damage in the joints. For precautions and doses, see “Medicines for Pain”.
Indomethacin (Indocin) is less safe for children than ibuprofen. Do not give to children under 2, and for older children use the smallest dose that works to avoid heart and liver problems.
Never use phenylbutazone. This is a drug for animals and should not be used by people.
For patients who have not responded to ibuprofen completely, other medicines such as sulfasalazine, gold, hydroxychloroquine, and methotrexate are available. These medicines should be used only by experts who treat arthritis.
Corticosteroids such as prednisone, have a strong anti-inflammatory effect but also can cause serious health problems. Corticosteroids weaken bones, slow growth, and make a child's body less able to fight infection. Corticosteroids should be used at the lowest dose possible and for the shortest amount of time possible.
Sources
- National Institute for Health and Care Excellence (2020) British National Formulary 80
- UpToDate (2021) Indomethacin: Drug information
- UpToDate (2021) Nonsteroidal anti-inflammatory drug (NSAID) poisoning
- UpToDate (2021) Systemic juvenile idiopathic arthritis: Treatment and prognosis
- UpToDate (2021) Use of gold compounds in rheumatic diseases
- World Helath Organization (2019) World Health Organization model list of essential medicines for children: 7th list 2019