Nonpharmacological management for rheumatoid factor-negative polyarticular JIA
Nonpharmacological interventions have an important role in the management of rheumatoid factor (RF)–negative polyarticular juvenile idiopathic arthritis (JIA) and are best delivered by a multidisciplinary team. The individual components may include:
- participation in physical activity
- use of psychological techniques
- finding opportunities for social connection.
Children and adolescents with RF-negative polyarticular JIA may require targeted stretching and strengthening exercises, delivered by a physiotherapist or occupational therapist, in order to:
- maintain full range of motion of all joints
- optimise muscle strength (especially in the context of muscle atrophy)
- manage limb length discrepancies and joint contractures
- address gait abnormalities
- maintain full function.
Children with RF-negative polyarticular JIA are encouraged to remain active, including participating in sport. If physical activity causes discomfort, reassessment is recommended because symptoms may be due to an arthritis flare or there may be an alternative explanation for the pain (eg a benign mechanical condition).
Also consider age-appropriate, nonpharmacological acute pain management strategies.