There is no known cure for juvenile arthritis (JA), although many children outgrow the symptoms. For some children, the symptoms, especially joint pain, may continue into adulthood. During childhood, the focus of treatment remains in protecting the joints and maintaining proper bone growth and development. Most treatment plans for JA involve regular monitoring of children and medications to ease their joint pain.

Exercise, physical therapy and occupational therapy can be a regular part of treatment. Parents may be reluctant to have their children exercise because of pain or inactivity. However, a physician and physical therapist can provide guidance for safe levels of exercise that help recovery. Some children may need a specific therapy plan to learn how to recover any lost range of motion and how to protect their joints. A physical or occupational therapist may recommend ways to maintain a child's normal bone growth, such as splints or joint-protection techniques. Treatment plans that educate family members and the child's school community about JA and its effects can also prove beneficial. Usually a therapist works with a school therapist to address issues at school.

Heat and water treatments - thermotherapy and hydrotherapy - may also help relieve pain and increase range of motion.

Regular monitoring of JA and its effects on other systems is essential. Children with types of JA that have eye complications should receive eye examinations by an ophthalmologist (physician who specializes in eye diseases) at least every six months or more often if recommended. Dentists should also be aware of children diagnosed with JA. Arthritis pain in the jaw may make chewing difficult or make children more reluctant to brush their teeth.

The most common treatments for JA are medications. An entire range of prescription and nonprescription medications are used to alleviate pain and inflammation. Medications used to treat JA include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are used to reduce pain and inflammation. They are considered the first line of treatment for most forms of JA. Many children respond to NSAIDs without additional drugs. NSAIDs come in prescription and nonprescription forms. Some may affect renal or gastrointestinal function. Aspirin is generally not recommended for children because of the risk of Reye's syndrome, a rare but potentially fatal condition that affects organs through the body.
  
  
• Disease-modifying antirheumatic drugs (DMARDs). This category includes many types of drugs that suppress the autoimmune response of juvenile rheumatoid arthritis (JRA) and other conditions. They are a second line of treatment, after NSAIDs. DMARDs work long–term and can take several months to produce results. All DMARDs have some side effects, including gastrointestinal problems, serious liver or kidney complications, rashes or repressed immune responses to infection. DMARDs are often taken months or years after symptoms have disappeared to ensure that arthritis does not recur.
  
  
• Biologic response modifiers (BRMs). Drugs that slow progression of the disease and inhibit the production of the proteins called cytokines, which contribute to inflammation. BRMs block proteins that cause inflammation, such as tumor necrosis factor (TNF) or interleukin-1. These drugs may be prescribed for some children with ankylosing spondylitis and some with JRA who have not experienced relief from other treatments.
  
  
• Corticosteroids. Used for their immunosuppressant and anti-inflammatory qualities. They may be given intravenously or as pills for certain forms or as an injection in one inflamed joint. For serious cases of JRA, corticosteroids may be used to stop systemic symptoms such as pericarditis (inflammation of the heart sac). Corticosteroids are used with caution in children because they may interfere with growth, weaken bones and increase susceptibility to infections, fractures, osteoporosis, diabetes and other conditions, especially if taken for a long period of time. Corticosteroids in eyedrop form may be used for eye inflammation related to JRA. Some topical corticosteroid creams are used for psoriatic arthritis.

• Antibiotics. Forms of JA that involve bacterial infection, such as juvenile Reiter's syndrome, may require antibiotics.

All medications have some side effects, which may vary from patient to patient. Physicians monitor their patients and may adapt the medications depending on response and side effects.

Surgery is rarely used for juvenile forms of arthritis. In some cases, surgical repairs are made to bones that grow unevenly because of arthritis. However, most physicians wait until children are grown to evaluate the health of their bones and determine that the arthritis flare-ups have ended.

Splints may also be used in cases where inflammation threatens to cause severe damage to joints or deformities. Splints can be worn during sleep or rest to hold a child's joint in a more therapeutic position, or a child can wear the splints during the day to help protect a joint during a specific activity, such as writing.

There is no known way to prevent JA. However, early intervention and careful monitoring of children with these diseases can limit its effect on the child into adulthood. Healthy levels of exercise (approved by a physician) can help maintain muscle strength and minimize the likelihood of joint injury.

Parents or guardians of children with JA should try to make life as close to normal as possible for their youngsters. Regular attendance at school and participation in extracurricular activities if possible is usually recommended. Although a child with JA will require special treatment in many instances, parents should try not to become overly permissive or blame the child for the condition. Educating teachers, coaches and other authority figures in a child's life on the facts of JA can help make the child's life outside the home more normal. Joining a support group and explaining the disease to the child is helpful in coping up with this chronic illness.

Though JA does not have a cure, proper treatment should allow a child to achieve normal physical, social and intellectual development.