Juvenile Arthritis Sufferers Feel Aches of Old Age
Growing pains come and go for most kids, but those with juvenile arthritis may endure chronic pain that can trigger a domino effect of dilemmas, say pediatric experts at Baylor College of Medicine in Houston.
"Whether you have pain in one joint or five joints, if you're a kid you feel miserable," said Dr. Barry Myones, associate professor of pediatrics and immunology at BCM. "Juvenile arthritis isn't necessarily long-term, but it may cause physical damage and a lot of mental and physical debility."
Myones, also a member of the section of rheumatology at Texas Children's Hospital and head of research in the Pediatric Rheumatology Center, estimates that 80 to 90 percent of children with arthritis eventually grow out of their condition, which could last between two and 15 years, but many will sustain long-term problems, such as permanent cartilage damage or joint deformity.
In addition to physical pain, many juvenile arthritis sufferers must cope with depression and other psychological repercussions from not participating in social or physical activities (such as sports) at critical times during their childhood or adolescence.
"Juvenile arthritis affects the kind of person these patients will develop into," Myones said. "With joint disease, you might look different than your peers. A lot of our patients try to hide it, they don't want to have to explain it to others."
Myones and his staff regularly stay in touch with school administrators, teachers, and nurses, who require medical clearance when a student abstains from P.E. or needs extra time getting from one classroom to the next. Some school districts are less understanding than others, especially when school absences accumulate, Myones says.
"Although there is no specific cognitive impairment associated with juvenile arthritis, obviously if you hurt and you can't get to class or cannot concentrate, you can't do your homework, and therefore you don't learn," Myones said. "If that gets into a bad enough cycle, it becomes a major problem for the kids in school and can affect the whole family."
Fortunately, a new generation of biological modifier medications, also known as "biologics," specifically block immunological signals as opposed to older therapies that blanket the whole immune system. Newer treatments and a better understanding of juvenile arthritis are on the horizon.
About a dozen ongoing studies nationwide are analyzing genetic roots of the disease and fall into two categories - those that try to foretell which children might develop arthritis and those that predict how severe a given case will become. Myones and his colleagues at BCM and Texas Children's Hospital are currently heading a study funded by the Arthritis Foundation that includes researchers at the University of Texas Health Science Center at Houston, the University of Miami and the University of Chicago.
"Right now we tell our patients that roughly 80 to 90 percent get better, but we are