Whole body

What It Is

Juvenile rheumatoid arthritis is an older name for what doctors now call juvenile idiopathic arthritis, or JIA (Barut et al., 2017). JIA is the most common type of long-lasting arthritis in children, and it starts before the age of 16 (NIAMS, 2024a). The condition causes persistent joint pain, swelling and stiffness. Some children have symptoms for a few months, while others continue to have them for many years or into adulthood (NIAMS, 2024a; Cleveland Clinic, 2025).

Some forms of JIA can cause serious problems, such as eye inflammation (uveitis) and growth problems (NIAMS, 2024a). Treating the condition is focused on improving function, preventing damage to the joints and controlling pain.

JIA happens when the body's immune system mistakenly attacks some of its own healthy cells and tissues. The cause isn't known, but scientists believe a complex mix of genes and environmental factors is involved (NIAMS, 2024a), and infection may be one possible trigger (Cleveland Clinic, 2025).

Juvenile Rheumatoid Arthritis Anatomy

For JIA, the most important part of the anatomy to understand is the joints. The joints affected vary from one child to the next, and the type of JIA affects which joints become swollen or inflamed (NIAMS, 2024a; Cleveland Clinic, 2025):

Oligoarticular JIA (once called pauciarticular): affects four or fewer joints, most often the knees or ankles, and sometimes the elbows.
Polyarticular JIA: affects five or more joints in the first six months, often the same joints on both sides of the body, including the small joints of the hands and feet and sometimes the neck and jaw.
Systemic JIA: as well as arthritis, this type causes fevers and a rash that come and go, and it can affect internal organs.
Enthesitis-related JIA (also called juvenile spondyloarthritis, which includes what used to be called juvenile ankylosing spondylitis): affects the places where tendons and ligaments attach to bone, and often the hips, knees, ankles and feet; the joints at the base of the back and in the spine can also become inflamed.
Psoriatic JIA: arthritis together with the skin condition psoriasis.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Juvenile Rheumatoid Arthritis

Therapy, exercise and activity are an important part of treatment (NIAMS, 2024b). Working alongside your child's medical team, I can help keep your child's joints flexible and muscles strong, with gentle hands-on care and a home exercise programme. See the My Approach tab for how I work.

1. Therapy

A physical therapist helps to keep the joints flexible and maintain muscle strength and range of movement, and can develop a home exercise programme for your child (NIAMS, 2024b). An occupational therapist can teach ways to protect the joints and manage daily activities (NIAMS, 2024b). Splints can sometimes reduce pain and swelling around a painful joint, but talk to your child's doctor before using one (NIAMS, 2024b). I can help you work out whether a splint might help and where to have one fitted.

2. Activity

Exercise and activity help maintain joint mobility and muscle strength, and can also improve sleep, reduce pain and help keep a healthy weight (NIAMS, 2024b). Exercise does not make arthritis worse (Cleveland Clinic, 2025). Your child should rest more when the arthritis is active and exercise more when it is not (NIAMS, 2024b). Swimming is especially helpful because it uses many muscles and joints without stressing them; cycling or gym ball exercises may also suit some children. Talk to your child's doctor before starting an exercise programme, and I can guide you on the right exercises at each stage.

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Options outside my scope

Anti-inflammatory medicines (NSAIDs): these can ease pain and swelling, but they do not change the course of the arthritis (Cleveland Clinic, 2025).
Disease-modifying anti-rheumatic drugs (DMARDs): medicines that calm the immune system to help stop the disease getting worse and protect the joints (NIAMS, 2024b).
Biological medicines (biologics), such as TNF blockers: these block specific immune signals that cause inflammation and can help reduce pain, swelling and morning stiffness (NIAMS, 2024b).
Steroid joint injections: an injection of a steroid into an affected joint usually brings fast relief, although it does not always last (NIAMS, 2024b).

How I can help (see the My Approach tab)

Gentle hands-on care for stiff, sore joints and muscles
A home exercise programme, with clear directions for you as parent or caregiver
Help working out whether a splint might help

Tips

Exercise is important because it promotes joint flexibility and muscle strength.
Stiffness is common, especially in the morning and after a nap or sitting for a long time (NIAMS, 2024a). Cold packs can help ease swelling and numb painful joints, while warmth, such as a hot shower or heating pad, works best for stiff joints and muscles (NIAMS, 2024b).
A healthy, balanced diet is important (NIAMS, 2024b). Children with JIA can develop weaker bones, both from the disease and as a side effect of some medicines such as steroids, so good nutrition, including enough calcium and vitamin D, matters (Barut et al., 2017). Ask your child's medical team whether your child needs anything extra.
Most forms of JIA are more common in girls, although enthesitis-related JIA is more common in boys and systemic JIA affects boys and girls equally (NIAMS, 2024a).
JIA can interfere with your child's bone growth; growth usually improves when the inflammation is well controlled (NIAMS, 2024a).
Make sure your child has regular eye checks with an eye specialist (NIAMS, 2024a).

Treatment

My Approach

Your child's medical team leads, and their treatment does the main work of controlling JIA. I work alongside them, follow any limits they set, and aim to ease pain and stiffness and keep your child strong and active. I check in at the start of every session, as whether the arthritis is flaring shapes what we do.

I assess which joints are affected, how they move, and your child's strength and balance. Parents and caregivers are welcome to sit in, with your child's agreement; if your child is too young to agree to treatment, you decide for them.

When It's Flaring

Gentler, shorter sessions, avoiding the most inflamed joints
Cool applications for swollen joints and soothing massage elsewhere
Easy movement only, with no stretching, forceful work or friction over sore tendon attachments

When It's Settled

Warm applications and hands-on work for morning stiffness and tight muscles
Gentle joint mobilisation and stretching within a comfortable range
Play-based strength and balance work, starting with body weight
I'll show you how to help your child with stretches, exercises, cold packs and warmth at home

If the neck is affected, I avoid moving the top of the neck. If pain lasts more than about an hour after a session, we scale back. I don't treat when your child has a fever.

What to Expect

Typical Course

Typical course: JIA is long-term, so care is ongoing alongside the medical team. Most families come weekly at first, sometimes twice a week, with a reassessment at about 4 to 6 weeks, then every few weeks. Expect flexibility and strength to improve gradually over the first couple of months, at a pace set by how well the inflammation is controlled.

What I Focus On

Working With Your Child's Team

Flare-Aware Care

Joint Flexibility

Play-Based Strength

Home Programme for Parents

Sources

References

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (2024a) Juvenile idiopathic arthritis (JIA). Available at: https://www.niams.nih.gov/health-topics/juvenile-arthritis (Accessed: 7 October 2026).
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (2024b) Juvenile arthritis: diagnosis, treatment, and steps to take. Available at: https://www.niams.nih.gov/health-topics/juvenile-arthritis/diagnosis-treatment-and-steps-to-take (Accessed: 7 October 2026).
Cleveland Clinic (2025) Juvenile idiopathic arthritis (JIA). Available at: https://my.clevelandclinic.org/health/diseases/10370-juvenile-idiopathic-arthritis (Accessed: 7 October 2026).
Barut, K. et al. (2017) 'Juvenile idiopathic arthritis', Balkan Medical Journal, 34(2), pp. 90-101. doi: 10.4274/balkanmedj.2017.0111.

Massage therapy · Kitchener–WaterlooJuvenile Rheumatoid Arthritis (now called Juvenile Idiopathic Arthritis)

What It Is

Juvenile Rheumatoid Arthritis Anatomy

Self-Care & Treatment

How to Treat Juvenile Rheumatoid Arthritis

1. Therapy

2. Activity

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Tips

My Approach

When It's Flaring

When It's Settled

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooJuvenile Rheumatoid Arthritis (now called Juvenile Idiopathic Arthritis)

What It Is

Juvenile Rheumatoid Arthritis Anatomy

Self-Care & Treatment

How to Treat Juvenile Rheumatoid Arthritis

1. Therapy

2. Activity

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Tips

My Approach

When It's Flaring

When It's Settled

Typical Course

References

Related Conditions

Chronic Fatigue Syndrome

Reactive Arthritis

Benign Hypermobility Joint Syndrome

Osteoarthritis

Book a session