Hesperian Health Guides
More Information About Juvenile Arthritis
There are 3 types of juvenile arthritis:
- Fever type: There are times during the day when the child has a high fever, a rash, and feels ill and tired. He looks very sick. The joint pain seems less important, and it begins days or months after the other signs. There may be severe anemia (child looks pale).
- Many-joints type: More than 5 joints with pain. The child hurts a lot, and moves very little. Often severe contractures develop. The child does not grow much, and his sexual development is delayed.
- Few-joints type: Fewer than 5 joints affected. It can affect more joints after months or years. If the back is affected, it is more likely that severe arthritis will continue when he is adult. iritis
What causes it?
The exact cause of juvenile arthritis is not known, but it has something to do with the body’s ‘immune system’ (defenses against disease). This begins to attack not only germs, but parts of the body itself. The problem is usually not hereditary, and is not related to climate, diet, or the child’s way of life. It is not caused by anything the parents may have done. It cannot spread from one child to another. It does not affect the child’s intelligence.
Will the child get worse, or better? What about her future?
The progress of the disease varies a lot. Typically, there are times when the joints become very painful, and times when they hurt less. Often the joint pain and disability will get worse and worse for several years, then gradually start to improve. Two out of 3 children will stop having active arthritis after 10 years, although the damage already done to the joints may cause some permanent disability. Some children will continue to have arthritis when they are adults, but it is usually milder.
Most children with arthritis will become adults who walk, work, and have full and happy lives.
How does it affect the child and her family?
A child with severe arthritis suffers a lot. After a night of being kept awake by the pain, the child may be irritable, sad, and dull. But when the pain is less, she may be friendly and lively.
Since the arthritis often continues to get worse for years, even with all efforts to cure it, both the child and her family may lose hope and stop trying.
Also, the family may not understand how much the child is suffering, because the cause of the pain does not show. (In children’s arthritis the joints do not usually get red, as they do in adults.) So the family sometimes calls the child a ‘cry-baby’ or a trouble-maker. The child may feel abandoned or guilty. The situation is very hard on the whole family.
The family needs the help and support of understanding neighbors, health workers, and, if possible, a rehabilitation worker. They need to understand that by continuing exercises, therapy, and medicines—often for years—the child does have hopes of getting better. If therapy takes the form of games with other children and family members, it may help both her body and spirit.
When parts of the body do not get enough movement or exercises, joint contractures are common. With time, the bones may become fused (joined together) or dislocated. Also, the muscles that straighten the arms and legs become very weak. However, with exercises and with enough movement and good positioning, all these problems can be prevented or made less severe.