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Principles of medical treatment and therapy

Childhood arthritis is managed through a combination of medicines, daily exercises, and splinting. The main principles for the whole healthcare team and family are to:

Sometimes other modes of treatment are used as well, and a wide variety of healthcare professionals become involved. For everyone, there needs to be a balance between what seems important today and what is best for the child in the longer term. For example, it may seem kinder to let the child rest today, but we know that if the child rests too much her joints will slowly cease to work, causing considerably more pain and problems in the future.

What about real life?
The reality is that this is a long term, mostly painful condition requiring complex daily treatment, and there is no cure. Experienced specialists know that the majority of children outlive active arthritis, and that the quality of life the person achieves and degree of deformity they have to live with will depend upon:

1. how severe the disease was,
2. how quickly the child got effective treatment,
3. how the individual child coped with the challenge of arthritis,
4. the daily effort of her family, especially her parents, to fit a complex programme of exercises, splinting, and medicines into family life in the long term,
5. and the ability of the parents, especially the mother, to secure supportive services to meet the needs of the family.

There is little choice about the first item, and sometimes there seems little choice about the remaining four. However, a considerable amount can be achieved when the parents become informed about arthritis, treatment options, ways of supporting the children, how to conduct the exercise and splinting options at home, and how to reach services that could help the family. That is the task of this handbook.