Helping your child live with a rheumatic condition

When your child is diagnosed with a rheumatic condition, it is important to explain their condition to them in basic terms and listen to their concerns and feelings. You can help them manage their condition by:

• trialling pain management strategies to find a combination that works
• prioritising activities that your child enjoys, particularly activities they can do with friends and family
• encouraging exercise and stretching through play to maintain joint function
• encouraging a balanced diet low in fats and sugars
• helping your child relax with massages, warm baths and story time (for younger children).

Conserve energy

Plan your child’s days in advance so they can conserve their energy and still do all the things that are important to them.

Plan ahead and prioritise

• Consider how your child’s body moves during activities and how they can avoid positions which cause discomfort.
• Alternate between moving and sitting activities.
• Gather items before starting a task (e.g. utensils for cooking) to reduce unnecessary movement.
• Break tasks into stages and cut out unnecessary steps (e.g. when preparing for a writing activity, ask a school “buddy” to help your child get the writing utensils and clear up).

Set a realistic pace

• Learn how your child’s condition changes throughout the day.
• Schedule rest breaks during long periods of exercise or travel.
• Set achievable goals based on what your child can manage.
• Practise breathing and body relaxation techniques with your child.
• Ensure your child’s routine includes adequate sleep.

Joint protection

It’s important to help your child minimise stress on their joints. This will reduce pain and discomfort, save energy and prevent possible joint damage or deformity.

Pain warns your child when they may be placing too much stress on their joints. If they feel pain, they need to stop the activity and rest. Pay close attention to your child‘s energy levels to make sure that they do not overexert themselves to the point of exhaustion or injury.

Reduce stressful positions

• Avoid awkward twisting and bending movements.
• Avoid heavy lifting.
• Ask your child to hold objects close to their body.
• Ensure your child wears splints if recommended by their occupational therapist.
• Encourage stretch breaks and regular position changes.

Use the strongest joints

• Use larger, stronger joints (i.e. knees, shoulders, hips.) as much as possible,
• Distribute weight evenly where possible.
• Push rather than pull objects. Use the palms (instead of fingers) to carry objects and support the object’s weight on forearms.

Family routines

Family routines will provide predictability, structure and reassurance for your child. This will also help you plan activities around your child’s energy levels and discomfort threshold.

Explain to your child that they may need to avoid doing certain things for a while but they can go back to them when they feel better.

Relaxation and leisure

Mindfulness

Mindfulness is awareness of your emotions in the present moment. It’s been shown to help with pain management but takes some time to practise. Mindfulness apps and guided meditations may help your child and can be accessed on the Internet.

Exercise and leisure

Exercise can help reduce your child’s joint stiffness and improve muscle strength. However, if your child is in pain or you’ve noticed they are fatigued, consider less active roles such as being an umpire or referee. This will enable them to keep participating.

Remember to balance your child’s activity and rest, and ensure they stretch and warm-up to help reduce potential pain and swelling.

Encourage your child to take up yoga, tai chi or dancing classes as these are gentle on joints and provide opportunities to stretch and strengthen (talk to your instructor about precautions). Swimming also provides exercise without placing weight on joints and muscles.

Strategies for school

Partner with your school

School is an important part of your child’s life and some simple steps can make a huge difference to their learning and friendships. Meet with your child’s teacher, principal and school councillor to discuss your child’s diagnosis, medications and educate them on how to recognise when your child may be encountering difficulties

Attendance and uniform

Rheumatoid symptoms can sometimes flare up unpredictably. When this happens, your child may be too unwell to attend school for the day or will need to start class at a later time. You could:

• speak to your child’s teacher about attending only core subjects or reduced class periods and make a plan for a gradual return to school
• keep your child’s friends informed so your child feels less isolated
• keep your child linked to school via online learning.

If your child has difficulties changing into their physical education clothes at school, speak to the teacher about allowing your child to leave class early so they have more time to change.

Classroom strategies

Your child’s joints may become stiff and painful if they spend too much time sitting. To avoid this, ask the teacher if your child can have a movement break every 10-20 minutes. This might involve standing up for a quick stretch.

Prolonged periods of writing and carrying may cause pain in your child’s hands. You could speak to your child’s teacher about using a laptop for written assignments and finding a student “buddy” to help with lifting and carrying.

Access

Your child may find that walking tires their muscles and joints, and they need more time to reach their destination. You could arrange for your child to leave classes slightly earlier or leave the house earlier to help them reach classes on time.

Help your child plan the shortest possible routes between classes and avoid stairs, if necessary.

For more information

• Rheumatology Service
• Arthritis Australia

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

Resource ID: FS217. Reviewed: March 2022.

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.