Arthritis in children - treatment of childhood joint arthritis, symptoms and causes

Causes of arthritis in children

Joint inflammation in children can occur under the influence of a number of external and internal factors.

The most common causes of the disease are:

previous bacterial or viral infections (inflammatory processes in the organs of the urinary system and in the digestive tract are especially dangerous);
joint injuries (fractures, bruises, hematomas);
surgical interventions performed in violation of the rules of antisepsis and asepsis;
autoimmune diseases (for example, juvenile rheumatoid arthritis occurs due to a malfunction of the immune system, which begins to negatively perceive body tissues and produces antibodies against them, which leads to inflammation Source: Arthritis in primary immunodeficiencies. Boyarchuk O.R., Volyanskaya L.A. ., Kovalchuk T.A., Kinash M.I. Pain. Joints. Spine No. 1, 2021. pp. 15-20);
mechanical damage to the joint due to heavy lifting, too intense training, obesity;
hereditary predisposition.

Physical therapy for knee arthritis

Daily therapeutic exercises for knee arthritis help slow the progression of the disease and reduce the load on the joint by strengthening the muscles and connective tissue. It also reduces pain and discomfort, helps maintain and even restore mobility in the joint.

Examples of exercises for knee arthritis:

Stand straight, with your back to the wall. Raise your leg to the side so that your shin is touching the wall and your big toe is facing forward, then lower it.
With your arms folded across your chest, sit on a chair, keeping your back straight. Slowly rise from the chair, and then slowly lower yourself down.
Standing straight, lift your ankle behind your back so that your heel touches your buttocks. Do not help yourself with your hands unless this is indicated in the exercise for knee arthritis! After 3 seconds, lower your leg.
Lie on your side on the floor and place your bent arm under your head. Bend your knee and hip joint approximately 90° and lift your knee as high as possible.
Lying on your stomach, rest your forearm on the floor in front of you. Bend the knee opposite your forearm and, grabbing your ankle with your hand, slowly pull your leg up. During exercises for knee arthritis, the muscles on the front of the thigh should stretch. Then roll over onto your back and, holding your leg under your knee, pull it towards your chest, feeling the stretch in your back muscles.
Perform the “lying bicycle” exercise until noticeable signs of fatigue appear. Avoid suddenly throwing your leg forward - if the leg muscles are not strong enough for prolonged work, it is better to return to the exercise later.

All exercises for arthritis of the knee joint should be performed 15 times on each leg or (for example, “bicycle”) for at least 1 minute.

Creating an individual set of exercises for knee arthritis and teaching the correct technique should be carried out by a qualified instructor.

Please note that exercise therapy for knee arthritis is only allowed in a state of remission. When arthritis worsens, rest is advisable.

Symptoms of arthritis in children

The main signs of arthritis in a child:

limited mobility in the area of the affected joint - if the baby does not yet walk, he will try to limit movements of the affected arm or leg; older children begin to limp and take care of the affected limb;
redness of the skin over the lesion;
swelling at the site of inflammation;
general weakness;
increased body temperature not associated with infectious diseases - in acute arthritis, the temperature can rise to 39 degrees Celsius; in the chronic form, low-grade fever is observed (around 37 degrees Celsius).

If one or more of the above symptoms is present, it is recommended to immediately take the child to the doctor and undergo an examination. The sooner treatment for arthritis is started, the better the prognosis of the disease.

Efficiency of local remedies

When you need to provide help quickly, to numb a specific area of inflammation, it is good to use ointment for arthritis, because it delivers the medicine directly to the site of the disease.

These ointments have the following positive results:

Providing an anti-inflammatory effect, it also relieves pain.
They improve blood supply to the affected area by regulating blood flow.
Relieves muscles from spasms.
Deliver nutrients to the bones and cartilage of affected joints.

Ointments will help relieve inflammation
Ointments for arthritis have several categories regarding their purpose.

Diagnosis of arthritis in children

At the first appointment, the specialist assesses the child’s general well-being, listens to complaints, conducts an examination and determines the current state of health of the affected joints.

The protocol for diagnosing arthritis in children includes the following laboratory and instrumental examination methods:

blood test (biochemical, general) - detect the presence of an inflammatory process in the child’s body;
blood test for inflammatory markers (C-reactive protein, fibrinogen and a number of others);
blood test for MCV (a marker of rheumatoid arthritis) and HLA-B27 (a marker of ankylosing spondylitis);
radiography - assesses the degree of bone tissue damage in the area of the affected joints;
Ultrasound - assesses the condition of the cartilaginous surfaces, the size of the cavity of the affected joint, the volume of synovial fluid;
MRI, CT - usually prescribed in complex clinical cases when it is not possible to make an accurate diagnosis using other research methods.

Another effective method for diagnosing the disease is arthroscopy. This is an endoscopic procedure during which a special thin probe with a video camera at the end is inserted into the cavity of the affected joint. Thanks to this, the doctor can examine the lesion from the inside. Source: Problems of early diagnosis of arthritis. Kazantseva N.Yu. Siberian Medical Journal (Irkutsk), 2007. p. 28-29.

The only disadvantage of arthroscopy is its invasiveness. Therefore, this study is prescribed as a last resort, when all other diagnostic methods do not allow an accurate diagnosis. If, during the examination of the child, damage to other organs and systems is detected, then a consultation with related specialists (infectious disease specialist, cardiologist, ophthalmologist, orthopedist) is indicated.

Classification of the disease

The following main types of arthritis in children are distinguished:

Rheumatoid arthritis. It is one of the manifestations of rheumatism, the cause of its development is a previous streptococcal infection (scarlet fever, tonsillitis, pharyngitis).
Juvenile rheumatoid arthritis. This is a chronic inflammatory disease of the joints of unknown origin. This pathology usually occurs in children under 16 years of age, has a progressive course, and can cause complications in internal organs. The main forms of juvenile arthritis are articular (one or more joints are affected) and systemic (the lungs, heart muscle, visual organs and a number of others are affected).
Ankylosing juvenile spondylitis (another name for ankylosing spondylosis). Affects peripheral joints and spine and can occur in childhood.
Infectious arthritis. Develops as a complication of bacterial, fungal, viral, and parasitic infections. The causative agents of the disease enter the joint through the blood and lymph, causing the development of an inflammatory process. In addition, pathogenic microflora can enter the joint as a result of injuries or improperly performed medical procedures.
Reactive arthritis. This is a group of inflammatory aseptic joint pathologies that occur after an extra-articular infection.

Treatment of arthritis in children

When the first suspicious symptoms appear, the child should immediately make an appointment with a rheumatologist. Timely treatment will improve the chances of a full recovery and avoid the disease becoming chronic. Source: Chronic arthritis in children. Bregel L.V., Knyazeva T.S., Krupskaya T.S., Baturina L.M. Siberian Medical Journal (Irkutsk), 2002. p. 100-104. If, in addition to the joints, the child’s other organs are affected, then consultation with doctors of related specialties may be necessary.

If a child has an elevated body temperature or experiences severe pain in the area of the affected joint, he is hospitalized or prescribed strict bed rest. After relief of the above symptoms, therapy can be continued at home, periodically visiting a doctor to assess the current results of treatment.

Clinical recommendations for arthritis in children are based on an integrated approach to treatment. The choice of specific methods and medications depends on the type and severity of arthritis, the general health of the child, his age, the presence of concomitant diseases, and the individual characteristics of the body.

Treatment of all types of the disease is aimed at achieving the following goals:

normalization of metabolism, restoration of normal blood flow speed in the lesion, removal of congestion;
increasing immunity;
relieving pain, inflammation, muscle spasms;
removing decay and inflammation products from the patient’s body, removing intoxication;
saturation of affected joints with nutrients to accelerate the process of tissue regeneration;
restoration of motor function.

The main methods of treatment for children are drug therapy, exercise therapy, physiotherapy, and massage. The choice of medications is made by the attending physician, individually for each patient. Self-medication is unacceptable!

To treat arthritis, analgesics, NSAIDs, glucocorticosteroids, immunomodulators, vitamins, antibiotics, antitumor and antirheumatic drugs can be prescribed. Many drugs are potent and, if the recommended dosages are not followed, lead to the development of side effects. Therefore, if a child develops any questionable symptoms, he should be immediately shown to a doctor.

One of the most effective methods of treating joint inflammation in children is physical therapy. The most commonly used techniques are ultrasound, electrophoresis, inductothermy, therapeutic mud, exposure to pulsed currents, and paraffin therapy. Magnetic therapy also helps a lot. It combines perfectly with other physiotherapeutic and medicinal treatment methods, enhancing their effectiveness, has a gentle, gentle effect on the affected joint and can be used even during exacerbation of the disease.

After stopping the acute stage, professional medical massage gives good results.

Physical therapy improves the child’s overall well-being and strengthens joint health. In the absence of severe pain, it is useful to take walks, ride a bike, or swim. At the same time, increased physical activity and participation in traumatic sports (football, hockey, volleyball, basketball, running, jumping, weightlifting, etc.) are contraindicated for arthritis. For some types of arthritis, the child is advised to wear special orthopedic devices (splints, orthoses, insoles) .

For quick recovery and prevention of relapses, a special low-calorie diet for arthritis in children is recommended. It is necessary to reduce the amount of carbohydrates and liquids in the diet, eliminate fast food, fried, salty, pickled, smoked foods, sweet soda, and chips. Food should contain more vitamin D and calcium. This is necessary to strengthen joint and bone tissue.

In addition to the main therapy, folk remedies for the treatment of arthritis in children can be used (in consultation with the attending physician): tinctures of hops, horsetail, clay compresses, thistle decoction, pine baths.

In particularly advanced cases, when conservative therapy no longer helps, surgery may be prescribed. Indications for surgical intervention are severe deformities of the affected joints, rapid progression of arthritis with the involvement of internal organs and tissues in the pathological process. During the operation, the surgeon washes and disinfects the cavity of the affected joint and removes inflammatory exudate. At extreme stages, the joint can be removed and then replaced with an artificial analogue.

Degrees and stages of knee arthritis

There are 4 stages of the pathological process:

Arthritis of the knee joint 1st degree. There are usually no obvious symptoms. There may be slight morning stiffness of the joint, slight swelling, and increased fatigue. With grade 1 arthritis of the knee joint, the pain is not severe and is periodic and irregular (“pinched”). At this stage, doctors usually give a positive answer to patients' questions about whether knee arthritis can be cured. A complete cure is possible.
Arthritis of the knee joint 2 degrees. The pain syndrome is noticeably expressed, swelling of the joint is clearly visible. An unpleasant crunching sound may occur when bending your legs. With grade 2 arthritis of the knee joint, redness of the skin and a local increase in temperature begin.
Arthritis of the knee joint grade 3. From the side, the deformation of the joint is noticeable, the patient’s gait changes. The pain is felt constantly, interfering with normal daily activities and significantly limiting the patient even when taking medications for knee arthritis.
Arthritis of the knee joint 4 degrees. The joints become ankylosed (fused) and almost completely lose mobility. Irreversible changes affect the bones. The leg muscles suffer from contractures, and the ligaments shorten. At this stage, surgery is required.

Prevention of arthritis in children

First of all, it is necessary to eliminate, if possible, all provoking factors. Of course, if we are talking about genetic predisposition, then there is nothing much you can do. But you can treat a sore throat in time, properly distribute physical activity, provide the child with proper nutrition, avoid contact with people with ARVI, harden up, follow a work-rest schedule, periodically take multivitamins, and so on.

If your family has close relatives with arthritis, it is recommended to visit a rheumatologist at least once a year for a preventive examination. This will allow you to identify arthritis in the early stages and begin treatment in a timely manner.

Sources:

Chronic arthritis in children. Bregel L.V., Knyazeva T.S., Krupskaya T.S., Baturina L.M. Siberian Medical Journal (Irkutsk), 2002. p. 100-104
Problems of early diagnosis of arthritis. Kazantseva N.Yu. Siberian Medical Journal (Irkutsk), 2007. p. 28-29
Arthritis in primary immunodeficiencies. Boyarchuk O.R., Volyanskaya L.A., Kovalchuk T.A., Kinash M.I. Pain. Joints. Spine No. 1, 2017. p. 15-20

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Recipes for folk remedies

Another type is folk treatment. There are many recipes for ointments and lotions for arthritis and arthrosis. We will present some of them, but before using them, consult your doctor.

This composition includes 4 parts linseed oil, 1 part turpentine and 1 part propolis. Store in a cool place and warm up before use. Recommended use: 2 times a day.
To prepare the ointment, you need to take 10 parts of wax, 3 parts of chopped horseradish, 0.5 parts of bee venom and two parts of propolis. Apply twice a day, store in a cool place.
This composition is prepared from herbs: hops, St. John's wort, sweet clover - 10 g each. Next, grind with 50 g of petroleum jelly. All this is infused in a transparent jar for a week, and then applied twice a day.

The best way to combat arthritis is comprehensive. Let your attending physician decide what exactly this complex will consist of.

Bibliography:

https://revmatolog.net/lechenie/medicamenty/15-samyh-effektivnyh-mazej-ot-arthrita