The most common type of arthritis in children and adolescents is Juvenile idiopathic arthritis aka (JIA) a type of inflammatory arthritis that affects kids 16 years and younger. It is a rare condition, that affects around 1 in every 1,000 children. It can cause joint pain and stiffness throughout the body, especially the facet joints/spinal joints.
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Types of Arthritis that Fall Under JIA
Juvenile Idiopathic arthritis was known as juvenile rheumatoid arthritis, but it is not a child/teenage version of adult rheumatoid arthritis. Juvenile Idiopathic arthritis falls into a group of several types of arthritis. When a doctor diagnoses JIA, they will determine the type.
Different types include:
- Systemic
- Oligoarticular
- Polyarticular
- Undifferentiated
- Psoriatic
- Enthesitis-related JIA that affects the spine is enthesitis-related.
How It Affects the Spine
To better understand how this arthritis affects the spine, it helps to know some of the terminology.
- Enthesitis: Inflammation of the entheses is the area where tendons and ligaments connect to bone/s.
- Spondyloarthritis: Arthritis that attacks the entheses of the spine. Ankylosing spondylitis is an example of spondyloarthritis.
The neck joints are the most common to be attacked by JIA. Whereas, spondyloarthritis causes pain and stiffness in the low back.
Typical Symptoms
Juvenile idiopathic arthritis happens in children aged 16 years and younger. Symptoms include:
- Joint pain
- Swelling
- Stiffness
- Tenderness
- Mild heat or a warmness that has been present for at least 6 weeks.
Other symptoms can include muscles and soft tissues becoming tight, erosion of the bone, joint misalignment, and abnormal growth patterns.
Diagnosis Can Be A Challenge
Diagnosis is not always straightforward, and there are criteria for diagnosing juvenile idiopathic arthritis. The doctor will perform a physical exam and order tests. They will monitor the child’s symptoms for at least 6 weeks initially, and then for 6 months after the onset of the disease. During this time, figuring the number of joints involved helps determine the diagnosis. As joint involvement can vary by the type of arthritis, and symptoms can and do change regularly.
This arthritis attacks the joints of the spine, specifically in the neck. However, with certain types of spondyloarthropathy, the lower back can become the target.
Diagnosing arthritis involves a complete and thorough examination. If a chiropractor has been brought in to help with the case, a medical work-up by a rheumatologist could be recommended. This includes radiology/X-rays or an MRI, urine, blood analysis and physical examinations.
Treatment
A doctor may recommend a multi-disciplinary approach to treat JIA. They may prescribe various types of therapies/treatments focused on stopping the disease’s progression. The treatment plan will include teaching healthy habits to prevent future back pain.
Medication/s
Treatment usually starts with nonsteroidal anti-inflammatory’s. A doctor can also prescribe a corticosteroid to control the inflammation. Most respond well to anti-inflammatory medication, however, these medicines do not treat the underlying disease or the root cause.
Inflammatory arthritis and its progression can be controlled with certain medications. There are disease-modifying antirheumatic medications that can slow the disease’s progression. There are also TNF-blocking medications that can help block a specific protein known as tumor necrosis factor that causes inflammation. Etanercept known on the market as Enbrel and adalimumab aka Humira are examples of TNF-blockers that can prevent the disease from progressing.
Chiropractic
Understand that chiropractic medicine cannot cure arthritis, but it can help alleviate the symptoms and slow the progression. They will use spinal adjustments in conjunction with other treatments. These can include:
- Hot and cold treatments
- Ultrasound
- Massage
- Electronic muscle stimulation
- Magnet therapy
- Physical rehabilitation
Physical Therapy Exercise
Focuses on:
- Proper posture
- Joint mobility
- Deep breathing
- Exercises
- Healthy lifestyle education
Patients can develop a forward posture that can lead to a hunched back and neck pain. Postural training and back extension exercises are helpful. Stretching and range of motion exercises keep the facet and rib joints functioning and mobile. Deep breathing expands the chest which expands the rib joints and aids lung function. Depending on the type and severity, a doctor might try other approaches like spine surgery.
Optimal Results
If you or someone has been diagnosed with juvenile idiopathic arthritis in the spine, learn as much as possible about the disease and the ways to combat it. Being informed about this or any disease encourages empowerment and engagement throughout the treatment process.
The best results are achieved by attacking it from all angles. Working with a chiropractor and rheumatologist in combination. A chiropractor will train the individual on how to maintain a healthy diet and maintain an active exercise program to help with movement. This is geared toward a healthy outcome.
Low Back & Neck Pain Chiropractic Care
NCBI Resources
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