There’s probably not a single kid with JA who hasn’t wished their arthritis would just go away. And sometimes it does – at least for a while. But even if it doesn’t go away completely, it’s often possible to get pain and other symptoms to a level that you barely even notice them. Really!
In fact, most kids and teens with JA can achieve a low level of disease activity, often referred to as remission. That’s because doctors are treating JA earlier and more aggressively than they once did, thanks to newer and better medications.
What Is Remission?
Remission basically means that you have no or few symptoms of arthritis, but a group of doctors called the Childhood Arthritis and Rheumatology Research Alliance (CARRA) have developed a more specific definition.
According to their guidelines, your JA is in remission if you have:
• no swollen, painful or hot joints
• no fever, rash or swelling of the tissues lining the lungs, heart, abdomen or other organs
• no enlargement of the spleen or lymph nodes
• no active eye inflammation (uveitis)
The rules also decide how long symptoms need to be gone to be called remission. If you are on meds and have no symptoms for six months, you are in remission. If you are off meds, you must go at least 12 months without symptoms to be in remission.
How to Get to Remission
The most important thing you can do to get to remission is see your doctor regularly and take your medications – even when you don’t feel like it and even on days you feel fine. There are many medications that can help you get to remission. If the first one your doctor prescribes doesn’t do it, he may switch you to a different one or add another.
Remission doesn’t always happen and when it does, it usually doesn’t happen quickly. Try to be patient while you wait for your medicines to work. But don’t be afraid to speak up if you’re still in a lot of pain. Your doctor can see if your joints are hot or swollen, but only you know how you feel. Maybe your joints feel pretty good, but you’re tired all the time. So, you must let your doctor know what’s going on so he or she can help you feel better.
Although taking your medications is the most important thing you can do, taking good care of yourself can help, too. Eat healthy foods, exercise a lot and get plenty of sleep – even if you’re invited to a sleepover or have a big test the next day. Both activity and rest are important for controlling your disease.
Remission Isn’t Always Forever
If you are on medications and haven’t had symptoms for at least six months, your doctor may recommend stopping some or all your medications to see if you can stay in remission without them. Never stop taking your medicines without your doctor’s permission. If you stop taking them before your disease is well-controlled, it will likely get worse as soon as the medicines are out of your system.
Sometimes remission lasts a long time, but for most kids and teens there will be times when arthritis returns – or flares. Lots of things may trigger flares, including infections, stress or intense physical activity, but sometimes the cause isn’t obvious. Sometimes flares happen even when you are taking your medicine and doing everything right.
The good news is that flares don’t last forever. If your arthritis becomes active again after a time of remission, your doctor will restart your medication. If your arthritis flares while you are taking medication, he or she may change medicines or add a new one. This can help get your arthritis back under control.
Even if your arthritis doesn’t go away completely – or forever – remember there’s a good chance you can go through times with few or no symptoms. Taking your medicines, taking care of yourself and working closely with your doctor are the best things you can do to make this happen.