What is Juvenile Rheumatoid Arthritis?

• Rheumatoid arthritis (RA) is an autoimmune disorder. The body's immune system malfunctions and attacks the synovial membranes between the bones. These membranes allow the bones to move against one another without pain. When attacked, they no longer facilitate easy movement. Rheumatoid arthritis typically affects the hands or feet, localized to the affected joint and may be temporary or permanent. Regardless, the damage done to joints is permanent.
  
  In the acute stages, there is pain, redness, swelling, and heat in the affected joints. In the sub-acute stages, there may be stiffness and mild discomfort, but movement is relatively pain-free.
  
  Juvenile rheumatoid arthritis (JRA) develops when a child is observed with persistent arthritis, lasting six weeks or more in one or more joints. Typically, it is diagnosed in children between 1 and 3 years of age and in children 8 to 12 years of age. Common symptoms include stiffness and soreness, especially after being still for a while, and night pain.
  
  

Benefits of Massage on JRA

• Massage is shown to help lower blood pressure, relieve soreness and stiffness, improve flexibility and contribute to overall well-being. For children with JRA, the relaxation aspect of massage can help a child sleep at night, giving them much-needed rest to develop and grow into adulthood. Research from the Touch Research Institute shows that a daily massage session lasting 15 minutes a day for 30 days led to a decrease in pain, reduction in anxiety and stress while sleep levels improved.
  
  

Massage Techniques for JRA

• This routine takes 15 minutes and should be performed nightly, preferably before the child goes to sleep.
  
  1. Have the child lay on his back. Apply a light coat of massage oil or lotion on your hands, and gently stroke his forehead with your fingertips. Work across the bridge of the nose, onto the cheeks and along the jawline and neck using the pads of your fingers.
  
  2. Move to the abdomen. Using over-and-over hand strokes (similar to a paddle-wheel), stroke in a clockwise direction around the abdomen. Take care not to make contact with the ribs to prevent damage to the ribcage and promote healthy digestion.
  
  3. Move to the legs. Using a wringing or twisting motion, work from the upper leg down to the ankles, such as rolling a sheet of paper. Massage the feet and toes, and give the Achilles tendon a gentle stretch. Use the same actions on the hands.
  
  4. Turn him over, and stroke the back. Use long, gentle strokes from the shoulders down to the hips, being careful to not put any pressure on the spine, and only gentle pressure along the ribcage. Use small circular movements with your fingertips along the shoulder blades and down along both sides of the spine. Run your hands across the back in a side-to-side motion, including his sides. Some children are ticklish, so work within your child's tolerance level. Remember, the key is to relax, not play.
  
  5. Finish by kneading the shoulders and neck gently.
  
  

Precautions

• As with any RA or JRA situation, never perform massage when the disease is in the acute stages, recognized by the presence of heat, pain, swelling and redness in the affected joints. This is to prevent spreading of the disease to adjacent joints in the body. Never use firm pressure in order to prevent broken bones and bruising. Always focus on the comfort of your child during the massage. Massage should never be performed when the child has an illness, a fever or any other ailment.
  
  

Other Treatments

• Other treatments include the use of splints, medications such as anti-inflammatory or pain medicines, and exercise. Prescription and OTC drugs such as anti-inflammatories and pain relievers offer immediate relief and can be used in conjunction with massage, with the ultimate goal of using massage exclusively for pain and stress relief. Discuss your options with your child's doctor to ensure the safety and health of your child.