Flaring in JIA

 Not feeling so good today?

The text book says - A ‘flare’ can be described as: ‘any worsening of disease activity that would, if persistent, in most cases lead to initiation or change of therapy; and a flare represents a cluster of symptoms of sufficient duration and intensity to require initiation, change, or increase in therapy.’

In plain English – During a flare one or more joints will become inflamed and feel tender/painful. If the joint is hot to the touch, the skin looks red and/or your child has a fever, it is important that they are seen by a health care  professional promptly. This is to ensure that there is no infection in the joint (this is not common but does need urgent treatment if this happens).

A flare can happen at any time, especially after an illness or a stressful period such as school exams. Along with an increase in joint pain, stiffness and swelling, your child may be feeling exhausted, and in a low mood.

The more your son or daughter keeps moving, the less their joints are likely to seize up; maintaining joint movement will help reduce the stiffness. This is especially important when you consider that your child is growing and ensuring
that joints maintain their full range of movement is key to avoiding longer term limitation of movement.

Managing these flares and the pain and fatigue that usually come with a flare can involve the use of a number of strategies; these include non-drug treatments such as using heat (e.g. a hot bath or heat pad) and cold (e.g. a bag of frozen peas on the joint, always wrapped in a tea towel) and relaxation and distraction techniques. Maintaining movement in all joints is important, as mentioned above, even in a flare, so gentle regular exercises will help to reduce stiffness when flaring.

Use pain killers effectively by ensuring that your child takes them regularly and doesn’t wait until the pain gets worse.

Many common relaxation techniques combine breathing more deeply with relaxing the muscles. Such techniques obviously work for older children who can understand what is being suggested. For some young people the first couple of times they try to deliberately relax can be challenging; it’s hard to focus, seems like a waste of time and isn’t working. Please encourage them to persevere and don’t give up on it too quickly.

Yoga and stretching are both good forms of exercise that can help to improve breathing and relaxation. Listening to music and “toe tensing” (repeatedly tightening and relaxing your toes) can also distract from the pain. There are lots of clips on YouTube about relaxing. The point is to focus on something other than the discomfort. Again this is an activity for older children and teenagers rather than young children.

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