Juvenile rheumatoid arthritis (JRA) is a chronic disease affecting more than 250,000 children 16 years or younger according 2007 information from the American Association of Orthopedic Surgeons (AAOS). Splinting is an adjunct therapy used to immobilize painful joints and reduce the possibility of deformity.
History
Autoimmune diseases attack your healthy cells. According to the AAOS, the causes of most autoimmune diseases are unknown. Scientists believe that some children have genes that make the occurrence of JRA more likely; however, juvenile arthritis is not hereditary. If one of your children is affected, it does not mean that your other children will be as well. The disease attacks the cells in your child's joints and may be triggered into activity following a viral illness or other type of stress.
Symptoms
For some children, the symptoms of JRA can be mild and seem to disappear on their own. For others, the joint pain, irritation, stiffness and deformity worsens over time until the child becomes disabled. The earliest sign is usually morning stiffness in one or more joints. Your child may limp because of knee pain. If your child has joint pain, stiffness or swelling for more than six weeks, there is a good possibility that he may have JRA. Take your child to your health care provider if he has joint symptoms that cannot be explained by trauma or that last six weeks or longer.
Importance of Splinting
The importance of splinting is discussed in an article titled, Plastic Splints in the Treatment of Juvenile Rheumatoid Arthritis published in the journal "Rheumatology." Your doctor may want your child to wear splints to help keep his joints in a neutral or specifically flexed position. The splints are used to balance joint activity and rest, help reduce symptoms during a flare and improve the chances that your child will not suffer joint deformity. Based on your child's affected joints and the severity of his symptoms, your doctor may suggest that he wear his splints only at night. If he is using wrist splints, he may be asked to wear them during the day as well. According to an article published in 2002 in "Arthritis & Rheumatism," the reviewers could not find clinical studies that supported the need to wear the wrist splints during the day. Work with your doctor to determine the right time for your child to wear his splints.
Types
In the past, splints were made of plaster of Paris, which caused multiple problems because they were heavy, uncomfortable, restrictive and caused skin breakdown. According to 2007 information from the AAOS, splints are now made of plastic with Velcro closures. The plastic splint can be custom-made relatively quickly so that it is an exact fit for your child. Splints can also be made of fabric with metal hinges and other types of material. The splints can be fabricated for almost any joint that your child's doctor believes needs to be immobilized including the wrist, fingers, knee, elbow, hand or neck. Your physical therapist will work with you to determine the best type of splint for your child's needs.
Considerations
Your child may have multiple joints affected during a JRA flare. It is not unusual for children to be uncooperative when it is time to apply a splint. It an be a challenge to convince a child to wear even one splint, especially if putting it on causes pain. Your child may protest the idea of having to wear multiple splints at once, especially if they are difficult to apply, heavy, uncomfortable or reduce her ability to pursue activities she enjoys. If you are like many parents, war with your child on a daily basis over wearing splints is something you want to avoid. Sometimes, parents give up because they cannot bear the arguments. Work with your child's physical therapist who can help you manage this challenge. Not wearing splints increases the possibility that your child will have permanent joint deformity.
