Can i play football with arthritis?

Child with JRA (Rheumatoid Arthritis)?

• Wondering if anyone can provide me with some help/answers. I have a son who is almost 13 yrs. old who ha been diagnosed with Juvenile Rheumatoid Arthritis(JRA). He was DX when he was very young-probably about 10 yrs. ago when he used to cry in the morning because his knees would hurt and I could feel "heat" coming from his knees, back then it was just pain in the knees in the mornings and the heat-NO SWELLING. So, his Dr. recommended physical therapy which I used to take him to a few times a week, and I believe I used to also give him some type of RX,although I don't recall which one it was. Anyhow, his condition improved within a year and it NEVER bothered him again, we moved out of state and switched Drs. and I always thought maybe he was misdiagnosed to begin with since there is no definitive test for JRA, and he never had any signs or problems for almost 10 years. Until recently, since mid 2008 he sometimes complained of his right knee hurting him sometimes, especially in the AM. His last Dr. thought nothing of it, she said it was probably just "growing pains", although I told her about the JRA when he was younger, she said she didn't think it was that & unless it started to REALLY bother him, I wouldn't worry about it. Then, Sept2008 we moved back to NY and in October he started to complain of the pain in his right knee just about every morning,& sometimes at night and even during the day when he was performing physical activities or simple things like walking up/down stairs. I would give him ibuprofen which had no effect & then one day he says to me that he thinks one leg looks bigger than the other, so I look at his right knee & I couldn't believe my eyes, his rigth knee was EXTREMELY SWOLLEN and puffy-TWICE the size of his left knee, and even the area above the knee (like the thigh area) looked bigger. I immediately got on the phone to call Drs., but I don't have insurance for him right now and don't have lots of extra money, although his health is very important so I tried to do all I could do. I got him an appt. the next day at a pediatrician who looked at the leg and I told him about his previous JRA & asked if that is what this was? Like I said before, when he was younger, his knees NEVER got swollen, only pain and heat in both knees in the morning but NEVER swollen. The pediatrician referred me to a pediatric rheumatologist but they told me they couldn't give me an appt. for 3 months, I felt this was an emergency and couldn't wait 3 months so I called around to every pediatric rheumatologist I could find & every one either could not give me an appt. that week or gave me the run around since I had no insurance. So, then I started calling regular rheumatologists and found a compassionate one who said I could come in right away. He examined my son & determined that he would need to see a pediatric rheumatologist since the course of treatment is different for children than for adults, he said if my son was 40 yrs. older he would have stuck a needle in his knee and drained the fluid out that was causing swelling, but this was not done to children so he made calls for me to get me an appt. with a pediatric specialist and got me an appt. a few days later (and told me to continue giving ibuprofen-WHICH NEVER HELPED). So, we see the PR (pediatric rheumatologist) who first orders blood tests to rule out other things (ie: lyme disease & other possible causes). After waiting a week for the test reults, they all came back negative, even his "rheumatoid factor" was negative, but they say that there is no definitive test for JRA and it is diagnosed by a determination of factors and symptoms and not one test alone. Since he had been dx with it when he was younger, and he has a cousin who has it, this is what she determined it to be and she recommended an injection into his knee which was supposed to reduce swelling and relieve the pain, this was supposed to take full effect in about 3 days. During this time now (since October) the PR gave him a note excusing him from playing gym in school until January since he was now haviing bad pains EVERY DAY and the knee was severely swollen and large, he missed school a few times because the pain was so bad in the morning that he could not get up and get ready for school in the morning & in school it hurst him to walk up/down stairs & walk to and from classes. She also told me to continue giving him ibuprofen (which still never helped). My son has also gained weight, almost 10 lbs. in the last 3 months because he is no longer active at all, he just sits in the house playing games because he no longer likes to play outside with friends (he used tobe very active playing football, riding his bike, etc, etc. etc.). His appt. t have the injection was in November (the earliest appt. they could give me) So, once he got the shot I thought he would be better. Well, he got the injection on a Friday, then on Saturday he said he said ne noticed a slight improv

• Answer:

  Get him involved in swimmimg. It is good exercise and does not stress the joints. Also warm baths. Massage. If he is missing school because of pain, ask for the school district for a 504 plan. Under this plan, he can get accomodations that include PT at school, extra time to change classes, an elevator pass, emergency evacuation plan, extra set of books for home. the school may have a health impaired program so if he is home from school, he gets a tutor. You need to call before a certain time. They may also provide a wheelchair or scooter just for school. Many PT offices will see people without health insurace for a very small fee or even free. If you leve near a PT school, many of the professors may treat for free as well as long as you have a script. JRA is autoimmune. Everyone is different. Email me if you have any questions, I am a Board certified pediatric board certfied physical therapist that works in the public schools. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/juvenilearthritis.asp http://www.arthritis.org/