What is juvenile psoriatic arthritis?

Psoriatic arthritis usually occurs in people who already have psoriasis. People with psoriatic arthritis experience symptoms of both the skin condition and arthritis.

When children and adolescents develop the condition, doctors diagnose them with juvenile psoriatic arthritis (JPsA).

Psoriatic arthritis (PsA) is an autoimmune disorder.

Medical experts believe that it develops when the immune system mistakenly attacks healthy skin cells, causing them to grow too quickly. The cells then build up to form red patches of flaky, crusty skin.

The immune system can also attack a person’s joints and cause pain and inflammation.

Psoriasis affects up to 7.5 million people in the United States. Every year, doctors diagnose around 20,000 children aged under 10 years with the condition.

Research suggests that around one-third of the children or adolescents with psoriasis also develop arthritis.

Symptoms

Symptoms of JPsA can vary considerably among individuals, but they may include:

  • stiffness, pain, and swelling of one or more joints, often located in the fingers or toes
  • pitted nails
  • stiffness in the morning and reduced range of movement
  • fatigue
  • swelling, redness, and pain in the eyes
  • a red and sometimes itchy rash on the joints, scalp, face, and trunk

Causes and risk factors

The medical community does not fully understand what causes JPsA, but it believes that a combination of genetics and environmental triggers may be responsible.

However, a parent may not always pass on the condition to their child, and some people develop JPsA without having a family history of the condition.

Also, environmental factors may trigger the onset of JPsA or cause existing symptoms to flare up.

Possible triggers of psoriasis may include:

  • emotional stress
  • skin damage or injury
  • certain medications
  • some infections, such as strep throat and respiratory infections
  • dietary factors
  • allergies
  • certain types of weather

JPsA most often appears between the ages of 11 and 12. Girls are more likely to develop it when they are younger and boys when they are older.

Some research suggests that young people who are overweight or obese may have an increased risk of developing JPsA.

Diagnosis

Early diagnosis improves the chances of successful treatment and the prevention of joint damage and other complications.

A doctor specializing in pediatrics, a dermatologist, or a rheumatologist will begin by performing a physical examination.

They will also ask the parent or caregiver if there is a family history of psoriasis or arthritis.

If the young person has characteristic symptoms of psoriasis, such as the telltale rash, the diagnosis is usually straightforward.

Otherwise, the doctor can perform several diagnostic tests, such as:

  • Antinuclear antibody blood test. The presence of certain antibodies in the blood can point to autoimmune disorders, including JPsA.
  • MRI or X-ray. These imaging tests can detect damage to the bones or joints.
  • Uric acid test. A raised level of uric acid in the urine can indicate JPsA.
  • Eye exam. The doctor may perform a more detailed examination of the child’s eyes to look for signs of inflammation that can point to JPsA.

Treatment

Treatment for JPsA aims to relieve pain, reduce swelling, and prevent further damage to the joints.

Medications, dietary changes, and physical therapy can help.

A doctor may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDS). These include over-the-counter painkillers, such as aspirin and ibuprofen, and some prescription medications. NSAIDS can reduce inflammation, joint pain, and stiffness.
  • Disease-modifying antirheumatic drugs (DMARDs). A doctor may prescribe these to relieve more severe symptoms. Corticosteroids and immunosuppressive drugs are some examples.
  • Biologics. A doctor prescribes these if a person with PsA has not responded to other drug therapies. Biologics are a protein-based drug that targets specific parts of the immune system.

Due to a lack of safety data, the U.S. Food and Drug Administration (FDA) have not approved most DMARDs and biologics for use in children.

However, some doctors may still prescribe these drugs when JPsA is severe or difficult to treat.

Dietary changes can also help some people with JPsA. A doctor may recommend:

  • Nutritional supplementation. Adjusting the diet or taking supplements to boost the intake of vitamin D and calcium can help. These nutrients strengthen and otherwise support the health of the bones.
  • Trigger avoidance. Some foods may trigger symptoms, and avoiding them may help to prevent flare-ups. However, there is limited research in this area.

Physical therapies may include:

  • Exercise. Exercise can strengthen joints and increase flexibility, and it also supports overall health and well-being. A physiotherapist can advise about the best exercise plan for each child.
  • Occupational therapy. An occupational therapist can help to address any issues a child may have when performing everyday tasks.
  • Hydrotherapy. This involves exercising in a warm pool, and it can be a gentle way to strengthen joints and improve flexibility. A physiotherapist usually supervises these sessions.

If a psoriatic rash is present, the doctor may recommend topical treatments, such as moisturizers and steroid creams or ointments.

Light therapy, or phototherapy, can also help to treat this type of rash. Sessions involve exposing the skin to ultraviolet light. A dermatologist will usually carry out these sessions in a clinic or hospital.

The following lifestyle changes can also help to reduce symptoms of JPsA:

  • avoiding smoke from cigarettes and other tobacco products, as secondhand smoke can trigger flare-ups in some children
  • eating a healthful and balanced diet
  • maintaining a healthy weight

Neck Pain & Causes

Neck pain

It is common for people to experience pain in the right side of the neck. In most cases, the pain occurs due to a muscle strain or another benign cause. People can often treat their pain using home remedies and medications. However, for severe or prolonged neck pain, it is best to see a doctor.

The neck is a vital part of the human body, comprising spinal bones, muscles, and other tissue. Unlike some other crucial parts of the body, the neck is exposed and at risk of injury. The neck is also prone to straining because people move it constantly throughout the day.

It is also common for a person to experience pain in connected areas, such as the shoulders, back, jaw, and head.

In this article, we discuss nine common causes of pain in the right side of the neck, as well as treatment options and when to see a doctor.

Causes of pain in the right side of the neck

Some of the most common causes of pain in the right side of the neck include the following:

1. Degeneration or wear and tear

Gradual wear and tear may cause pain on the right side of the neck.

The vertebrae and discs in the neck will wear down with age. As they degenerate, a person may experience chronic, or persistent, pain in the neck.

Some medical conditions can also cause the vertebrae, discs, and other parts of the neck to break down.

These conditions may include:

  • inflammation
  • pinched nerves
  • cervical fractures
  • arthritis
  • cervical disc degeneration

2. Bad sleeping position

It is common to wake up feeling stiffness or pain in the shoulders, back, or neck.The sleeping position that people adopt, the number of pillows that they use, and the firmness of the mattress can all affect how they feel waking up in the morning.

Falling asleep with either a lack of support for the head or the neck out of alignment increases the likelihood of waking up with a sore neck.

3. Non-specific neck pain

In some cases, it is difficult to identify the exact cause of neck pain.

Neck pain without an apparent cause often results from a minor sprain or tear to the muscle tissue. This type of pain is the most common neck pain.

The pain can sometimes be due to poor posture. Holding the neck out of alignment for extended periods can strain the muscles.

This is particularly true when a person is bent forward over their work for several hours during the day.

4. Stress and anxiety

Stress may cause the muscles to tighten. People often talk about holding tension in their neck and back, and they may feel pain from the excess strain.

5. Sudden-onset or acute torticollis

Torticollis is a medical condition in which the head becomes twisted to one side. It can be very painful to try to straighten out the head. The cause of torticollis is not always known.

Doctors suspect that most cases are due to minor ligament or muscle sprains in the neck, although exposing the neck to cold temperatures for an extended period could also be a cause.

Torticollis often occurs overnight, meaning that a person will have no symptoms when they go to bed but will wake up unable to move their neck. In most cases, the pain will subside after a few days and movement will return to normal.

Occasionally, torticollis may be a symptom of a more severe health issue. Some potential underlying causes of torticollis include tumors, infections, and side effects from taking medications.

6. Brachial plexus injury

If the nerves connecting the spinal cord to the hands are damaged, it may cause neck pain.

The American Society for Surgery of the Hand define the brachial plexus as a collection of nerves that connect the spinal cord in the neck to the hands.

If an injury to the neck affects the brachial plexus, pain may also occur in the hand.

A common cause of injury to the brachial plexus is blunt force trauma, which can happen as a result of a sporting injury or car accident.

7. Whiplash or a sudden jolt to the neck

Whiplash describes an injury to the neck where the head jolts forward and then back into place very quickly.

The movement resembles the crack of a whip. People tend to think of whiplash in relation to car accidents, but it can also occur as a result of sporting activities and other sudden movements.

8. Cervical radiculopathy

Cervical radiculopathy, which people often refer to as a pinched nerve, occurs when irritation of the nerves originating in the spinal cord in the neck causes pain to radiate down the arm.

Although this can result in pain in the neck, the primary symptoms include:

  • numbness in the arms
  • pins and needles in the arms
  • pain or weakness in part of the arms

The two most common causes of cervical radiculopathy are cervical spondylosis, or neck arthritis, and a prolapsed disc.

9. Rare causes of right side neck pain

There are less common causes of neck pain that may be more severe. These may include:

  • rheumatoid arthritis
  • cancer
  • serious injury
  • damage to the nerves, vertebrae, or spinal cord
  • infections
  • bone disorders

12 natural cough remedies tips 

Coughs play a role in clearing irritants and infections from the body, but persistent coughing can be annoying. The best treatment for a cough will depend on its underlying cause. There are many possible causes of coughs, including allergies, infections, and acid reflux.

Some natural remedies may help to relieve a cough. However, it is important to remember that the U.S. Food and Drug Administration (FDA) do not monitor herbs and supplements, so people who use them may be at risk of using low-quality products and impurities.

You should also be aware that some herbs and supplements can interfere with medications, which may result in unwanted side effects.

If a cough is severe or persists for more than a few weeks, it is essential to seek medical advice.

1. Honey tea

A popular home remedy for coughs is mixing honey with warm water.

According to some research, honey may relieve coughs.

A study on treatments for nighttime coughing in children compared dark honey with the cough-suppressing medication dextromethorphan and with no treatment.

The researchers reported that honey provided the most significant relief from coughing, followed by dextromethorphan.

Although the benefits of honey over dextromethorphan were small, parents rated honey most favorably of all three interventions.

To use honey to treat a cough, mix 2 teaspoons (tsp) with warm water or an herbal tea. Drink this mixture once or twice a day. Do not give honey to children under 1 year of age.

2. Ginger

Ginger may ease a dry or asthmatic cough, as it has anti-inflammatory properties. It may also relieve nausea and pain. One study suggests that some anti-inflammatory compounds in ginger can relax membranes in the airways, which could reduce coughing. The researchers mainly studied the effects of ginger on human cells and animals, so more research is necessary.Brew up a soothing ginger tea by adding 20–40 grams (g) of fresh ginger slices to a cup of hot water. Allow to steep for a few minutes before drinking. Add honey or lemon juice to improve the taste and further soothe a cough.

Be aware that, in some cases, ginger tea can cause stomach upset or heartburn.

3. Fluids

Staying hydrated is vital for those with a cough or cold. Research indicates that drinking liquids at room temperature can alleviate a cough, runny nose, and sneezing.

However, people with additional symptoms of a cold or flu may benefit from warming up their beverages. The same study reports that hot beverages alleviate even more symptoms, including a sore throat, chills, and fatigue.

The symptom relief was immediate and remained for a continued period after finishing the hot beverage.

Hot beverages that may be comforting include:

  • clear broths
  • herbal teas
  • decaffeinated black tea
  • warm water
  • warm fruit juices

4. Steam

A wet cough, which is one that produces mucus or phlegm, may improve with steam. Take a hot shower or bath and allow the bathroom to fill with steam. Stay in this steam for a few minutes until symptoms subside. Drink a glass of water afterward to cool down and prevent dehydration.

Alternatively, make a steam bowl. To do this, fill a large bowl with hot water. Add herbs or essential oils, such as eucalyptus or rosemary, which may also relieve decongestion. Lean over the bowl and place a towel over the head. This traps the steam. Inhale the vapors for 5 minutes. If the steam feels hot on the skin, discontinue until the skin cools down.

5. Marshmallow root

Marshmallow root is an herb that has a long history of use as a treatment for coughs and sore throats. The herb can ease irritation resulting from coughing because of its high mucilage content. Mucilage is a thick, gluey substance that coats the throat.

One small study revealed that an herbal cough syrup containing marshmallow root, along with thyme and ivy, effectively relieved coughs resulting from common colds and respiratory tract infections. After 12 days of taking the syrup, 90 percent of the participants rated its effectiveness as good or very good.

Marshmallow root is also available as a dried herb or a bagged tea. Add hot water to either and then drink it immediately or allow it to cool first. The longer the marshmallow root steeps in the water, the more mucilage will be in the drink.

Side effects can include stomach upset, but it may be possible to counter this by drinking extra fluids.

6. Salt-water gargle

This simple remedy is one of the most effective for treating a sore throat and wet cough. Salt water reduces phlegm and mucus in the back of the throat which can lessen the need to cough.

Stir half a teaspoon of salt into a cup of warm water until it dissolves. Allow the solution to cool slightly before using it to gargle. Let the mixture sit at the back of the throat for a few moments before spitting it out. Gargle with salt water several times each day until the cough improves.

Avoid giving salt water to younger children as they may not be able to gargle properly, and swallowing salt water can be dangerous.

7. Bromelain

Pineapples contain bromelain, which may help to treat a cough.

Bromelain is an enzyme that comes from pineapples. It is most plentiful in the core of the fruit.

Bromelain has anti-inflammatory properties and may also have mucolytic properties, which means that it can break down mucus and remove it from the body.

Some people drink pineapple juice daily to reduce mucus in the throat and suppress coughing. However, there may not be enough bromelain in the juice to relieve symptoms.

Bromelain supplements are available and may be more effective at relieving a cough. However, it is best to speak with a doctor before trying any new supplements.

It is possible to be allergic to bromelain, and this herb can also cause side effects and interact with medications. People who take blood thinners or specific antibiotics should not take bromelain.

8. Thyme

Thyme has both culinary and medicinal uses and is a common remedy for a cough, a sore throat, bronchitis, and digestive issues.

One study found that a cough syrup consisting of thyme and ivy leaves relieved coughing more effectively and more rapidly than a placebo syrup in people with acute bronchitis. Antioxidants in the plant may be responsible for its benefits.

To treat coughs using thyme, look for a cough syrup that contains this herb. Alternatively, make thyme tea by adding 2 tsp of dried thyme to a cup of hot water. Steep for 10 minutes before straining and drinking.

9. Dietary changes for acid reflux

Acid reflux is a common cause of a cough. Avoiding foods that can trigger acid reflux is one of the best ways to manage this condition and reduce the cough that accompanies it.

Every individual may have different reflux triggers that they need to avoid. People who are unsure of what causes their reflux can begin by eliminating the most common triggers from their diet and monitoring their symptoms.

The foods and beverages that most commonly trigger acid reflux include:

  • alcohol
  • caffeine
  • chocolate
  • citrus foods
  • fried and fatty foods
  • garlic and onions
  • mint
  • spices and spicy foods
  • tomatoes and tomato-based products

10. Slippery elm

Native Americans traditionally used slippery elm bark to treat coughing and digestive issues. Slippery elm is similar to marshmallow root as it contains a high level of mucilage, which helps to soothe a sore throat and cough.

Make slippery elm tea by adding 1 tsp of the dried herb to a cup of hot water. Steep for at least 10 minutes before drinking. It is important to note that slippery elm can interfere with the absorption of medications.

11. N-acetylcysteine (NAC)

NAC is a supplement that comes from the amino acid L-cysteine. Taking a daily dose may lessen the frequency and severity of a wet cough by reducing mucus in the airways.

A meta-analysis of 13 studies suggests that NAC can significantly and consistently reduce symptoms in people with chronic bronchitis. Chronic bronchitis is a prolonged inflammation of the airways that causes mucus build-up, a cough, and other symptoms.

The researchers suggest a daily dose of 600 milligrams (mg) of NAC for people without airway obstruction, and up to 1,200 mg where there is an obstruction.

NAC can have severe side effects, including hives, swelling, fever, and difficulty breathing. Anyone considering this approach should speak to a doctor first.

12. Probiotics

Miso soup is rich in probiotics.

Probiotics do not directly relieve a cough, but they may boost the immune system by balancing the bacteria in the gut.

A superior immune system can help to fight off infections or allergens that may be causing the cough.

One type of probiotic, a bacteria called Lactobacillus, provides a modest benefit in preventing the common cold, according to research.

Supplements containing Lactobacillus and other probiotics are available at health stores and drug stores.

Some foods are also naturally rich in probiotics, including:

  • miso soup
  • natural yogurt
  • kimchi
  • sauerkraut

However, the number and diversity of probiotic units in foods can vary greatly. It may be best to take probiotic supplements in addition to eating probiotic-rich foods.

Tips to help prevent a cold

It is not always possible to avoid getting a cough, but the following tips can reduce the risk:

  • Avoiding contact with people who are sick: Maintain a safe distance from people who have a head cold, flu, or a cough.
  • Washing hands regularly: Use soap and warm water to remove bacteria and viruses from the skin. Teach children how to wash their hands properly. Use an alcohol-based hand sanitizer outside the home when necessary.
  • Using disinfectant: When a family member is ill, clean the kitchen and bathroom regularly with a disinfectant. Wash bedding, towels, and soft toys on a hot wash.
  • Staying hydrated: Drink enough water, herbal teas, and other beverages to avoid dehydration.
  • Reducing stress: Stress affects the immune system and increases the risk of getting sick. To alleviate stress, a person can exercise regularly, meditate, do deep breathing, and try progressive muscle relaxation techniques.
  • Getting enough sleep: Aim to sleep for 7–9 hours each night to stay fit and healthy.
  • Taking immune-boosting supplements: Consider taking zinc, vitamin C, and probiotics during cold and flu season to keep illness at bay.

Allergy symptoms can sometimes mimic those of a cold. Reduce allergy flare-ups by avoiding triggers such as pollen, dust mites, animal dander, and mold. See a doctor about getting allergy shots or medications.

When to see a doctor

See a doctor if the following symptoms accompany a cough:

  • foul-smelling green or yellow phlegm
  • chills
  • dehydration
  • fever over 102°F
  • fever that lasts for more than 3 days
  • weakness

Call 911 or go to the nearest emergency department if a cough:

  • brings up blood
  • causes breathing difficulties