Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is the most common group of rheumatic diseases in childhood. It refers to arthritis affecting one or more joints that begins before the age of 16 and persists for 6 weeks or longer, after other known causes have been excluded.

TCM Pattern Differentiation and Medication Reference

| Common Symptoms

Clinical description:

Marked joint redness, swelling, and pain; increased local skin temperature on touch; restricted movement; severe, heavy muscle pain; a red tongue body, yellow, greasy coating, and a slippery, rapid pulse

In plain language:

  • Joints are noticeably red, swollen, and painful.
  • The skin over the affected area feels warmer than usual and hot to the touch.
  • Joint movement is restricted, and bending or turning the joint may feel stiff.
  • Muscles may be painful and feel heavy.
  • The tongue appears somewhat red when protruded.
  • The tongue coating is yellow and greasy.
  • The pulse feels slippery and somewhat rapid.

| Treatment Approach

Clinical description:

Clear heat, eliminate dampness, resolve impediment, and unblock the collaterals

In plain language:

  • Clear heat → Reduce internal heat and ease discomfort such as redness, swelling, a burning sensation, sore throat, thirst, and restlessness.
  • Eliminate dampness → Dispel dampness and turbidity in the body and ease heaviness, a sticky sensation, swelling or oozing, and a feeling of heaviness in the joints.
  • Resolve impediment → Disperse obstruction in the joints and channels so that the flow is restored and movement becomes more flexible.
  • Unblock the collaterals → Promote flow through the channels and microcirculation so qi and blood flow more smoothly, easing numbness, aching pain, and tightness.

| Related Products

The following products are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Si Miao Wan

| Common Symptoms

Clinical description:

Quotidian spiking fever, bright-red macules, red and swollen painful joints, dry stools and yellow urine, a red tongue body, yellow coating, and a rapid pulse

In plain language:

  • The temperature fluctuates but remains high overall, with a spiking fever pattern.
  • Bright-red macules may appear on the body.
  • Joints may be painful, red, and swollen, with discomfort during movement.
  • Stools may be hard and difficult to pass, and urine may appear yellow.
  • The tongue appears somewhat red when protruded.
  • The tongue coating is yellow.
  • The pulse feels rapid.

| Treatment Approach

Clinical description:

Clear heat, resolve toxins, dispel wind, and eliminate dampness

In plain language:

  • Clear heat → Reduce internal heat or signs of heat and ease discomfort such as redness, swelling, a burning sensation, sore throat, thirst, and irritability.
  • Resolve toxins → Clear inflammatory “toxic factors” in the body, reduce redness, swelling, suppuration, and odor from sores or ulcers, and promote healing.
  • Dispel wind → Disperse external wind pathogens and ease symptoms such as migrating aches, aversion to wind, and head and body pain.
  • Eliminate dampness → Dispel excess dampness and turbidity in the body and ease heaviness, a sticky sensation, swelling or oozing, and a feeling of heaviness in the joints.

| Related Products

The following products are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Si Miao Wan

| Common Symptoms

Clinical description:

Aversion to cold and cold limbs; severe joint pain without increased skin temperature, worsening with exposure to cold; a pale tongue body, white coating, and a thin, weak pulse

In plain language:

  • You may feel cold, and your hands and feet may often feel cool.
  • Joints may be severely painful. The skin over them does not feel warm, and pain may worsen in cold conditions.
  • The tongue appears somewhat pale when protruded.
  • The tongue coating is white.
  • The pulse feels thin and weak, with a less forceful beat.

| Treatment Approach

Clinical description:

Warm yang, dispel cold, promote dampness elimination, and invigorate the collaterals

In plain language:

  • Warm yang → Support yang qi and increase the body’s “energy and warmth,” addressing a tendency toward aversion to cold, cold limbs, fatigue, and excess dampness.
  • Dispel cold → Disperse cold in the body or affected area, ease cold-related pain and stiffness, and reduce discomfort that worsens with cold and improves with warmth.
  • Promote dampness elimination → Support fluid metabolism and elimination, dispelling dampness and turbidity through urine or sweat and easing heaviness, a sticky sensation, swelling, and heaviness in the limbs.
  • Invigorate the collaterals → Promote flow through the channels and microcirculation so qi and blood flow more smoothly, easing numbness, pulling pain, and restricted movement.

| Related Products

The following products are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

| Common Symptoms

Clinical description:

Long-standing illness; stiff, deformed joints; a thin body; a red tongue with little or no coating; and a deep, thin, weak pulse or a thin, rapid, weak pulse

In plain language:

  • The illness has lasted a long time, without noticeable improvement.
  • Joints may be stiff and inflexible, and appear deformed.
  • The person may appear thin or have a slight build.
  • The tongue may look red when protruded, with very little coating or almost none.
  • The pulse may be thin and weak and felt more clearly with deeper pressure, or thin and rapid but also weak.

| Treatment Approach

Clinical description:

Boost qi, nourish yin, and tonify the liver and kidneys

In plain language:

  • Boost qi → Support energy and organ function and strengthen qi, easing shortness of breath, fatigue, and reluctance to speak.
  • Nourish yin → Replenish yin fluids in the body and moisten dryness, easing discomfort such as dry mouth and throat, tidal fever, and night sweats.
  • Tonify the liver and kidneys → Nourish the essence, blood, yin, and yang of the liver and kidneys, addressing symptoms such as soreness and weakness in the lower back and knees, dizziness, tinnitus, and fatigue.

| Related Products

The following products are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

| Common Symptoms

Clinical description:

Joint stabbing pain, sometimes worse at night, with little apparent swelling; a dusky-red tongue body, petechiae or ecchymoses at the tip or edges, a thin white coating, and a thin, choppy pulse

In plain language:

  • Joints may have a stabbing pain, which may feel more noticeable with movement or pressure.
  • Pain may worsen at night, with discomfort more pronounced after dark than during the day.
  • Joint swelling may not be obvious; the joint may look much the same but still be painful.
  • The tongue may look dusky red rather than bright red when protruded.
  • Small purple spots or bruised-looking patches may be visible on the tip or edges of the tongue.
  • The tongue coating is thin and white.
  • The pulse feels thin and somewhat uneven or rough.

| Treatment Approach

Clinical description:

Invigorate blood, resolve stasis, relax the sinews, and unblock the collaterals

In plain language:

  • Invigorate blood → Promote blood flow and ease pain, stiffness, and numbness.
  • Resolve stasis → Disperse retained blood stasis and ease stabbing pain, fixed pain, and swelling.
  • Relax the sinews → Relax muscles and sinews, ease tightness, spasms, and pulling sensations, and improve restricted bending and stretching.
  • Unblock the collaterals → Promote flow through the channels and microcirculation so qi and blood flow more smoothly, easing numbness, aching and distension, and restricted movement.

| Related Products

The following products are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

References

  1. Wang Chengde, Shen Pi’an, Hu Yin’i. Practical Chinese Medicine Rheumatology [M]. Beijing: People’s Medical Publishing House, 2009.
  2. Ni Xin, Shen Kunling, Shen Ying. Zhu Futang’s Practical Pediatrics [M]. Beijing: People’s Medical Publishing House, 2014.
  3. Ye Zhizhong, He Weizhen. Pediatric Rheumatology [M]. Beijing: People’s Medical Publishing House, 2009.
  4. Zeng Huasong. International classification criteria and treatment of juvenile idiopathic arthritis [J]. Chinese Journal of Applied Clinical Pediatrics, 2011(9): 721-724.