Does paediatric physiotherapy treat juvenile idiopathic arthritis?

Juvenile idiopathic arthritis can cause inflamed, painful or stiff joints, and symptoms may change over time. A paediatric physiotherapist assesses joint movement, muscle strength, posture, walking, hand use, fatigue and participation at home or school. The programme may include gentle range-of-motion work, strengthening when appropriate, pacing, positioning and practical ways to make activities easier.

Physiotherapy is part of a wider plan. Medicines and rheumatology care address inflammation; the exercise plan may need to change during a flare. Forcing a swollen joint or continuing a demanding programme through significant pain can be unhelpful, so the child’s response should guide progression.

Ask the child’s rheumatology team whether physiotherapy is suitable now and share details about morning stiffness, swelling, pain, tiredness, school participation and preferred activities. A therapist can set achievable home exercises and advise on rest, joint protection, warmth or cold when appropriate.

Use the agreed plan consistently, but report a clear increase in swelling, pain or loss of function. Teachers and carers may need simple guidance about movement breaks, equipment and adapting sports without excluding the child from activity.

Contact the child’s medical team promptly for a new hot or swollen joint, worsening stiffness, a new limp, persistent fever, unusual tiredness or a noticeable loss of function. Urgent care is needed for severe pain, inability to use a limb, breathing difficulty or a serious injury.

Which joints and activities should therapy focus on? How should the programme change during a flare? What pain or swelling should be reported, and how will the rheumatology and physiotherapy teams coordinate the plan?