Juvenile rheumatoid arthritis (JRA) cannot be cured, although many children outgrow the symptoms. Some children have mild symptoms for a few years. The goal of treatment is to maintain a high level of physical and social functioning. For others, JRA affects and deforms the joints, causing pain and interfering with growth. Most treatment plans for JRA involve regular monitoring of children and medications to ease their joint pain.

Exercise can be a regular part of a child's treatment for JRA. Exercise helps to develop strong muscles and bones, keeps joints flexible and helps to build endurance. Some children may need physical therapy, occupational therapy or both to learn how to recover any lost range of motion, protect their joints and adapt to daily tasks. The 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 JRA and its effects can also prove beneficial. Joining a support group and explaining the disease to the child are helpful in coping with this chronic illness.

Regular monitoring of JRA and its effects on other systems is essential. Patients require periodic eye examinations by an ophthalmologist, at least every six months for those with pauciarticular or polyarticular JRA.

The most common treatments for JRA are medications. A range of prescription and nonprescription medications are used to alleviate the pain and inflammation. Some of the medications used to treat JRA include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are used to reduce pain and inflammation. They are considered the first line of treatment for all forms of JRA. Most children with pauciarticular JRA and some with polyarticular JRA respond to NSAIDs without additional drugs. NSAIDs come in prescription and nonprescription forms. Some may affect kidney 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 overactive immune response of JRA. 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, some serious liver or kidney complications and repressed immune responses to infection.
  
  
• 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 children with polyarticular JRA who have not experienced relief from other treatments.
  
  
• Corticosteroids. May be given as pills or injections. For serious cases of JRA, corticosteroids may be used to stop systemic symptoms such as pericarditis (inflammation of the heart sac). Corticosteroids may interfere with a child's growth, weaken bones and increase susceptibility to infections. They are prescribed at the lowest dose and for as short a time period as possible. Corticosteroids in eye drop form may be used for eye inflammation related to JRA.

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. Sometimes complimentary or alternate therapies, such as acupuncture, can be incorporated in treatment if the physician thinks it may help the child.

Surgery is rarely used to treat JRA. Certain types of arthroplasty might be recommended in some severe cases where a joint has become damaged.

People often outgrow the symptoms of JRA, and during childhood the disease need not be debilitating. One recent study found that, unlike some other rheumatic diseases, JRA was not linked with cognitive, emotional or social problems in children.

There is no way to prevent JRA. However, early intervention and careful monitoring of children with JRA can limit the progression of the disease.