What are the types of medications that are given in arthritis?
There are 3 or 4 types of medications that are given in Juvenile Arthritis.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS): These are normally given to reduce the pain, swelling and inflammation in children with arthritis. These act within a few hours. Although in very mild arthritis NSAIDS alone may be enough to control the disease, more often than not other medications (to be discussed) are required. It should be noted that there is no specific NSAID that is better than the others as regards efficacy. Often the NSAID, which, helps the child and at the same time does not cause side effects should be used. Gastrointestinal side effects are the commonest cause why these drugs are either changed or stopped.
Disease Modifying Anti-Rheumatic Drugs (DMARDS): These are slow acting drugs which can control the disease in the long run. These do not control the pain immediately. The commonly used DMARDS are chloroquine, methotrexate, salazopyrine etc. The specialist will explain the beneficial effects and the side effects of these medications and then start it. Regular monitoring of tests is a must on this drugs.
   Apart from the above-mentioned 3 DMARDS there are others which are more often than not used when the above 3 fail or there are contraindications to them. These have not been discussed in detail here.
Steroids: Corticosteroids are much-maligned drugs. Although like any other drug they have side effects, when used in an appropriate manner, they are extremely beneficial, especially in patients with severe polyarticular arthritis and systemic onset arthritis.
Calcium & Vitamin D: These supplements are given routinely in children with arthritis to prevent weakness of bones and to help the child achieve optimal bone strength in the future.
Iron supplements: Children with arthritis often have concomitant Iron deficiency and anemia. Iron supplements on routine basis take care of this deficiency.

What are the other therapies that children with arthritis would need?
Physiotherapy: Forms an integral part of treatment of children with arthritis. In the acute stages when there is excessive inflammation, the joint is rested. Once the inflammation is reduced, range movement exercises and, strengthening exercises are advised.

Orthotics and appliances: Children with deformities need assessment with a view to providing appliances and splints that would help lessen the disability.

Emotional needs: The amount of impact a chronic disease like arthritis has on a growing child is large. Children may have difficulties in schooling, interaction with other children, interaction with parents and relatives. All these should not be ignored and if needed the help of a child psychologist should be sought.

What role do climate and food have on arthritis?
There is no scientific proof to say that either hot /cold weather is the cause of arthritis. However sudden changes in temperature especially from hot to cold could worsen a pre-existing arthritis. Further since the level of activity goes down during cold weather the joint stiffness increases. When the disease is well controlled with appropriate medications one finds no relationship between the weather and the joint disease.

The kind of food eaten by and large does not affect the joints. Infact when the arthritis is active there is loss of weight and appetite. Hence there is no logic in doing any kind of dieting/food restriction. Less than 5% of children with arthritis have what is termed food allergy. This could be allergy to any kind of food including wheat-based food like chappati/ bread. These patients are told to avoid only that specific food.