Physical and occupational therapy
Physical therapy will be an important part of treatment if your child has severe JIA. The physical therapist can help set up an exercise program for your child, either for the child to do alone or to do with help from an adult. Exercises should be done every day and should be regularly reviewed by the physical therapist.3 The therapist will make sure that the exercises are being done correctly. He or she can decide whether any exercises should be added, dropped, or changed.
Occupational therapy helps a child live as independently as possible.
Any of the following may be used in physical or occupational therapy:
- Physical conditioning. It may include aerobic exercise, range-of-motion exercises, and strength and stretching exercises.
- Stretching and strengthening exercises. They can help a child maintain strength and a normal range of motion.
- Splinting at night. Splinting will help keep the wrist, hand, knee, and/or ankle joints straight. This may prevent pain, morning stiffness, and contractures. Working splints can help support a joint and relieve pain during writing or other hand tasks.
- Serial casting of the knees, ankles, wrists, fingers, and/or elbows. This is a temporary straightening and casting of the affected joint. The cast is then removed, and the child goes through some physical therapy. Then a new cast is applied with the joint stretched a bit more.
- Shoe lifts or inserts. These help to equalize leg lengths for children in whom one leg grows at a different rate than the other. For some types of inflammation in the feet, you can try using shoe inserts that transfer your weight onto your heel. This takes weight off the sore middle or front part of the foot.
Healthy eating
Healthy eating means eating a variety of foods so that your child gets the nutrients he or she needs for growth and development. Good nutrition may also help fight the effects of JIA. Your child can eat all types of food as long as his or her weekly intake is balanced and varied.
Talk to your child's doctor about healthy foods for children with JIA. There are a few nutrients that may be helpful. These include:
- Vitamin D and calcium, which can help control bone loss that is often linked with inactivity and with corticosteroid treatment.
- Vitamin C, which is an antioxidant that may help reduce inflammation in the body. It is found in citrus fruits, tomatoes, berries, broccoli, cabbage, and brussels sprouts.
- Omega-3 fatty acids in fish oil, which have been shown to mildly reduce inflammation in adults with rheumatoid arthritis. They may have the same effect in children who have JIA. The best sources of omega-3 fatty acids are cold-water fish and flaxseed oil.4