Best Flare Fighters for Kids With Arthritisby Lara DeSanto Health Writer
It’s hard to see your child in pain—and unfortunately, pain, stiffness, and difficulty moving are realities for children with juvenile idiopathic arthritis (JIA) during flares. Kids and teens with this autoimmune condition experience joint inflammation, the National Institutes of Health say, which leads to these frustrating symptoms no young person should have to deal with. To help your child feel their best, it’s important to learn the steps to reduce the risk of flares and what to do if one strikes. Keep reading for the best flare-fighting tips from the experts.
Take Medications on Schedule
One of the best ways to reduce the chance of a JIA flare-up is to make sure your child takes their medications on time, says Amir Orandi, M.D., pediatric rheumatologist at the Mayo Clinic in Rochester, MN. This can be tricky with kids. Setting alarms on your smartphone—or, if your child is old enough, empowering them to set their own—can be helpful, he says. And sometimes, it’s not the patient’s fault—refills may be delivered late: “If insurance allows, talk to your physician about getting a two- or three-month supply,” Dr. Orandi recommends.
Take Steps to Avoid Other Illnesses
One of the known triggers for JIA flares is getting an infection, like the flu, says Diane Brown, M.D., pediatric rheumatologist at Children’s Hospital Los Angeles. “Influenza is a notorious trigger of flares,” says Dr. Brown. “We ask our patients to get a flu shot every year.” Even a mild cold or stomach bug can be enough to flare JIA, says Dr. Orandi. In addition to that flu shot, make sure your kiddo knows proper handwashing technique and physically distances from those who are sick—and this goes for all times, not just during the time we're in now, says Dr. Brown.
Reduce the Risk of Injury
Sometimes kids play hard—and that can mean injuries. Unfortunately, injuries can trigger JIA flare-ups, says Dr. Brown. To help lower the chance of an injury, encourage your child to stay active within healthy limits. “Work your way toward more vigorous and more prolonged activities gradually as your arthritis and physical conditioning improves,” she suggests.
Track the Symptoms Closely
You don’t necessarily need to run to the doctor at the first sign of a JIA flare, says Dr. Orandi. “Record keeping or symptom monitoring is the first thing they should do—is it bothering the child early in the morning with increased stiffness, or all day? Was there an injury?” That said, if you’ve been tracking symptoms over a few days and things are getting worse, it’s time to make an appointment with your child’s rheumatologist, he says. They’ll evaluate the joints and determine whether your child needs a medication adjustment to bring down a flare.
Get Quality Exercise—or Gentle Movement When Flaring
“We know that a healthier body is good for keeping the effects of the disease under control and minimizing effects of disease,” says Dr. Orandi, and part of that means getting enough physical activity. “For younger children, that looks like active play, and for older kids that may be team sports or self-directed exercise,” he says. But what about during a flare? “Decrease intensity and duration of activity, but do not hold all activity; joints work best when they always have at least some gentle movement,” says Dr. Brown.
Eat a Healthy Diet
There’s no single diet recommended for JIA to fight flares, says Dr. Orandi. That said, he always recommends a healthy diet for people with JIA to help manage the disease. “I recommend a simple Mediterranean diet, and I tell them to avoid highly processed foods, especially drinks,” he says. “A Mediterranean diet means eating more fruits and vegetables, reducing red meat, and incorporating fish. That’s a good starting place.”
Use Over-the-Counter Pain Relief
If your child is dealing with a painful flare, taking a pain reliever—typically a nonsteroidal anti-inflammatory drug (NSAID)—on an as-needed basis can help reduce some of the soreness. Taking NSAIDs with food or a snack to help ease/reduce stomach side effects. “Often this will be naproxen (Aleve) or ibuprofen (Motrin, Advil), which will help with the ongoing inflammation as well as with pain relief,” Dr. Brown says. “Acetaminophen (Tylenol) can be used instead, but while it is a good pain reliever, it does little for inflammation and thus does not ‘treat’ the flare at all.’” Remember to check with your doctor before taking any new medications.
Use Heat, Cold, and Other Soothing Measures
Another great option for reducing JIA joint pain? Heat. “Warm packs, warm baths, and hot showers to warm up when cold and stiff can provide relief,” Dr. Brown says. After activity that may be hard on flaring joints, try things like ice packs, cooling and pain-relieving topical rubs, and massage. If your kiddo is experiencing a flare in the small joints of their hands, a paraffin bath can also be soothing, she adds.
Not getting quality sleep and having high stress may lead to flares, according to the Arthritis Foundation, and those flares make arthritis-related fatigue worse. Help your child establish a bedtime routine that winds them down, like listening to calm music or taking a warm bath, they suggest, and encourage them to keep a consistent sleep-wake schedule. Your child may need more sleep than you think—the National Sleep Foundation recommends nine to 11 hours for most school-age children.
Encourage Your Child to Listen to Their Body
Empower your child to get to know their JIA and what’s “normal” for them—and to speak up if they notice symptoms are getting worse or if something feels off, says the Arthritis Foundation. If your kiddo is having a good day, overdoing it can lead to a flare, Dr Brown says. Helping them learn to pace themselves is key: “Pay attention and listen to your body,” Dr. Brown says.