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 | Chronic Aches May Be More Than Growing Pains Your child complains about sharp pains in
his or her legs. At first, you dismiss the
symptoms as normal growing pains. But
the pain persists, and you feel confused and worried.
Is your child's pain really typical? Will it go away on
its own?
If your child suffers with chronic pain, it's time to see a doctor for an evaluation. Your family physician may recommend that your child see a pediatric rheumatologist, a doctor who specializes in diagnosing and treating arthritis, arthritis-related conditions and systemic autoimmune disorders in children. "Growing pains" may have nothing to do with growth, according to Norman Ilowite, MD, chief of the Division of Rheumatology at The Children's Hospital at Montefiore (CHAM) and a professor of Pediatrics at the Albert Einstein College of Medicine. "The common aches many call growing pains are usually harmless," he says. "But a small percentage of kids with chronic pain may have a potentially serious condition called juvenile rheumatoid arthritis."< The ABCs of JRAJuvenile rheumatoid arthritis (JRA) — the most common form of arthritis in children — strikes children 16 or younger. Experts don't know what causes JRA, but they suspect it occurs when the body's immune system malfunctions and starts attacking its own healthy cells.Doctors classify JRA into three main types. Pauciarticular JRA affects four or fewer joints. Polyarticular JRA involves five or more joints. Systemic JRA impacts the joints, as well as the heart and other internal organs. Some children with mild JRA have few problems. Others have uncomfortable and persistent joint symptoms, or high fevers and skin rashes that appear and disappear suddenly. In severe cases, JRA can lead to eye diseases, vision loss, inflammation of the internal organs and other serious complications. Learning and Coping With the DiagnosisAt CHAM, Dr. Ilowite and a dedicated team work closely together to provide children with comprehensive diagnostic services and clinical care. It all begins with a careful evaluation that may include laboratory tests and X-rays to rule out other conditions that can cause similar symptoms. Specialists may recommend oral medications, injections and infusion therapy as part of the treatment plan and use anesthetic creams or mild sedation to make sure children are as comfortable as possible during each procedure.Physical therapists at CHAM engage kids in special exercises that help maintain or improve their muscle tone and joint function. They also may fit children with splints or shoe inserts that make it easier for them to stay active. To help preserve their vision, children often are referred to CHAM ophthalmologists for thorough eye exams and close monitoring. "We use the latest treatments to help relieve kids' symptoms, improve their function and slow the progression of their disease," Dr. Ilowite says. "We know that kids aren't just small adults. So we monitor their nutritional status, growth, and social and emotional development." It can be difficult to learn that your child has JRA and not simply growing pains. But your child can get the expert care he or she needs at CHAM, and that's reassuring.
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