Living with a rheumatic disease

A child living with a rheumatic disease does not necessarily have to live a limited lifestyle. All the members of the family are affected by a child's diagnosis of rheumatic disease, so there must be an effort to maintain as normal a family activity pattern as possible. With proper management, a rheumatic disease may not have to hinder your child's daily activities over a long period of time.

Exercise and rheumatic diseases:

Exercise, when done correctly, can help reduce rheumatic disease symptoms, including:

• preventing joint stiffness.
• keeping muscles strong around the joints.
• improving joint flexibility.
• reducing swelling.
• reducing pain.
• maintaining strong and healthy bone and cartilage tissue.
• improving joint alignment.
• improving overall fitness.

Exercise is often times an integral part of a child's overall treatment plan for juvenile arthritis or other rheumatic diseases. In addition, exercise may help with increasing your child's sense of well-being. There are three main types of exercises that may be beneficial for children with rheumatic diseases:

• range-of-motion - Range-of-motion exercises focus on moving the joints in certain directions to improve flexibility and reduce stiffness.
• strengthening - Strengthening exercises help increase or maintain muscle strength around the joints, keeping joints more stable. Two common strengthening exercises include isometric (tightening muscles without using joints) and isotonic (strengthening muscles by using the joints).
• fitness - Fitness exercises improve a child's endurance and cardiovascular health, while keeping muscles strong and joints more flexible. Types of fitness exercises appropriate for most children with rheumatic diseases include walking, water exercise, and bicycling.

Always consult your child's physician before beginning any exercise program for your child. A physical therapist and/or an occupational therapist may be involved in your child's care to assist in exercise and therapy.

Diet and weight management and rheumatic diseases:

Researchers do not yet fully understand the role of diet and nutrition in rheumatic diseases. Studies are underway to examine the effects of food, weight, and nutrition on the disease. However, the Arthritis Foundation recommends the following dietary guidelines for children with juvenile arthritis and other rheumatic diseases:

• variety - Eating a variety of foods from the five different food groups supplies your child's body with the nutrients it needs. Fatigue, pain, and certain medications may make it more difficult for a child with rheumatic disease to eat healthy. Adequate calcium in the diet is recommended to keep bones healthy.
• weight - By helping your child maintain a healthy weight, there is reduced strain placed on his/her weight-bearing joints, such as the knees and hips. A nutritionist should be involved in managing your child's nutritional status.

Psycho-social management of rheumatic diseases:

Living with chronic pain and fatigue may leave your child feeling depressed and less able to cope with the pain. A cycle of pain, depression, and stress may keep a child from living his/her life to the fullest. Managing pain in a positive manner and taking charge can help break such a cycle. Part of proper pain management involves making sure your child is getting plenty of rest to preserve energy, including:

• adequate sleep - Adequate sleep is important in maintaining your child's energy level. Sleep also allows the joints to rest. Sometimes, an afternoon nap is beneficial in giving the joints a chance to rest.
• relaxation - Being able to relax can help minimize the stress in your child's life and, thus, minimize symptoms. A relaxed body means the muscles are relaxed, relieving some of the pain associated with rheumatic disease. Many different relaxation techniques exist. Consult your child's physician for more information.