Juvenile idiopathic arthritis flare-ups

Juvenile idiopathic arthritis (JIA) is a form of arthritis in children. When JIA is active or symptoms worsen, it’s known as a ‘flare’ or ‘flare-up’. Flare-ups may last days or weeks and can develop after an infection, or without any warning or apparent trigger. Flare-ups can be treated and managed.

Symptoms of a flare-up

• Swollen, warm or painful joints.
• Increased stiffness lasting for more than a few minutes, particularly in the morning or after sitting for a long time.
• Increased difficulty functioning and performing tasks (e.g. walking with a limp).
• Increased tiredness.
• Fever and rashes (some types of JIA).
• Pain and redness in eyes, difficulty looking at bright lights.

Treatment

• Anti-inflammatory medication such as Ibuprofen, Naproxen or Piroxicam should help reduce pain and inflammation but can take several days to have maximum effect. In many cases this will be enough to settle the flare.
  Important: Anti-inflammatory must be taken regularly as prescribed. If the medication is only taken on an ‘as required’ basis, the flare is much less likely to settle down.
• Use paracetamol (tablets or suspension) if required between anti-inflammatory medication. Be sure to keep track of when you’ve given a dose so that you don’t give it too frequently.
• Apply warm wheat bags or cold packs on inflamed joints. Make sure these are used as recommended.
• Take a warm bath or shower in the morning to help reduce stiffness.
• Move affected joint/s through their full range of movement regularly throughout the day if possible. Inactivity during a flare-up can make joints feel stiffer and more uncomfortable. See a physiotherapist if your child’s joint movement is restricted.

It’s important to treat flare-ups as soon as they occur to alleviate pain and prevent lasting joint damage.

Tips for minimising flare-ups

• Take prescribed medications as directed.
• Start flare-up treatment early.
• Ensure you have anti-inflammatory medication available at home for when it’s needed.

When to seek help

See your GP if your child has common symptoms, including:

• fevers or swollen joints
• problems with their medication
• a flare-up for more than 5 days.

Your GP can contact your child’s rheumatology care team if required and speak to the doctors directly.

If the flare-up continues after 2 weeks, despite anti-inflammatory medications, contact your child’s rheumatology care team. Do not wait until your child’s next rheumatology appointment, especially if your next appointment is not due for a long time.

Developed by Rheumatology Service, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS357. Reviewed: June 2021.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.