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Home > Cerebral Palsy > Cerebral Palsy Associated Disorders > Cerebral Palsy and
Arthritis
Last Updated: March 14, 2020


CEREBRAL PALSY AND ARTHRITIS

Page Medically Reviewed and Edited by Gina Jansheski, M.D.
Fact Checked

X

This article has been fact checked by a Board Certified Pediatrician. Sources of
information for the article are listed at the bottom.

For any content issues please Contact Us.

Cerebral palsy is not a degenerative condition, but it can cause secondary
conditions, some of which do get worse with time. One of these is
osteoarthritis, the pain, and stiffness in joints that results from wear and
tear on the cartilage over time. Children with cerebral palsy can have
increasing difficulty when they suffer from osteoarthritis because it can be
painful and limiting.

Both preventing and treating arthritis are essential for helping children and
adults with cerebral palsy have a better quality of life. Treatment to correct
musculoskeletal abnormalities can minimize damage to the joints, while good pain
management, and in some cases surgery, can treat arthritis and its symptoms
after its onset.


WHAT IS ARTHRITIS?

Arthritis is a common joint disease that has many forms and can affect a wide
range of people. There are, in fact, more than 100 types of arthritis.

In general, the term arthritis refers to inflammation and pain in the joints,
which causes swelling, pain, stiffness, redness, and difficulty moving the
joint. [1]
What Is Arthritis? (n.d.). Arthritis Foundation | Symptoms Treatments |
Prevention Tips | Pain Relief Advice.
Retrieved from:
https://arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis
It can affect any joint in the body, including the knuckles, elbows, shoulders,
hips, and knees.

The most common type of arthritis, and the type that most often affects people
with cerebral palsy, is osteoarthritis, also known as degenerative arthritis.
This is more frequently seen in older adults because it is caused by
deterioration in the joint cartilage with time and overuse of joints.

The cartilage is what provides cushioning within the joint, so when that wears
down, the result is pain, swelling, and stiffness.

Risk factors for the development of arthritis include a family history of
arthritis, being older, being overweight, having injured a joint, and having a
condition that causes unusual or excessive wear on joints, like cerebral palsy.
The symptoms of arthritis are generally chronic and progressive, and treatment
is needed to relieve the pain and swelling and to improve movement in the
joints.


HOW DOES CEREBRAL PALSY CAUSE ARTHRITIS?

Having cerebral palsy is a risk factor for osteoarthritis, but the degree of
risk, which joints are affected, and age of onset all vary by individual. As
children with CP age and enter adulthood, the risk of developing arthritis
heightens, according to a study published by the U.S. National Institutes of
Health. [2]
Emerging Issues in Cerebral Palsy Associated With Aging: A Physiatrist
Perspective. (n.d.). PubMed Central (PMC). National Institutes of Health.
Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637058/#b39-arm-2019-43-3-241

People with cerebral palsy have different degrees of abnormalities of the
neuromuscular system, and these abnormalities may cause unusual movements in the
joints, overuse of joints, excessive wear on joint cartilage, and compression of
the joints that ultimately lead to osteoarthritis.

Arthritis often begins earlier in someone with cerebral palsy than in the
general population, and it is sometimes even seen in children.

The joint or joints affected depend on the type of disability that a person with
cerebral palsy has. For instance, a child who struggles to walk, having a gait
that makes the hips or knees move in an abnormal way can lead to arthritis in
those joints.

Hip arthritis is fairly common for this reason in people with cerebral palsy.
Even joints not involved in walking can be affected. Muscle imbalance across a
joint is common in cerebral palsy. This can cause unusual movements of a
shoulder or elbow joint that leads to premature wear on the cartilage.


SYMPTOMS AND SIGNS OF ARTHRITIS

While many people with cerebral palsy will not experience arthritis until they
become adults, it is possible to develop it as children. Parents should be aware
of the signs of arthritis because earlier intervention will produce better
outcomes. The symptoms of osteoarthritis in any joint include:

 * Pain that occurs during or after movement in the joint
 * Stiffness in the joint, often after sleeping or a long period of little
   movement [3]
   Arthritis: Frequently Asked Questions (FAQs). (2019, February 21). Centers
   for Disease Control and Prevention.
   Retrieved from: https://www.cdc.gov/arthritis/basics/faqs.htm
 * Tenderness when the joint is touched
 * Inability to move or flex the joint through a full range
 * A feeling of grating inside a joint when it is moved
 * Hard lumps that can be felt under the skin around a joint


TREATMENT FOR ARTHRITIS

The treatment of arthritis in people of any age with cerebral palsy depends on
the individual, but there are some typical treatments that are used for many.

The least invasive types of treatment don’t really treat the inflammation but do
help with pain and mobility. These include painkillers, such as over-the-counter
acetaminophen, or nonsteroidal anti-inflammatory drugs such as ibuprofen. [4]
Juvenile ArthritisTypes and Treatments OrthoInfoAAOS. American Academy of
Orthopaedic Surgeons. (n.d.).
Retrieved from:
https://orthoinfo.aaos.org/en/diseases--conditions/juvenile-arthritis/

Treatment can also include physical therapy and gentle exercises that help to
strengthen specific muscles and make moving a joint easier and less painful.

When arthritis becomes more severe or debilitating, and these non-invasive
treatments provide little relief, more invasive strategies can be used, such as
surgery. It is sometimes possible for a problem causing the abnormal movements
or overuse of the joint to be improved with surgery. This is highly variable by
the individual.

For advanced cases of arthritis in a joint, a replacement of the entire joint
with an artificial one may relieve pain and restore mobility. Hip replacement
surgery has been found to be a safe way to treat adults with cerebral palsy who
suffer from severe osteoarthritis in the hip joint.


PREVENTION OF ARTHRITIS

Many people with cerebral palsy will develop some form of arthritis, and
preventing it completely may not be possible. However, there are ways to prevent
it to some degree, delay its onset, or minimize the damage and symptoms.

The critical step is to diagnose and begin treatment for cerebral palsy early in
childhood. The more comprehensive and consistent treatment a child gets, the
better the chances of reducing joint damage over time.

Any early and ongoing treatment that can help children and adults with cerebral
palsy move in healthier ways will minimize the development of arthritis. This
may mean surgery to correct bone or joint deformities, physical therapy and
exercise to develop muscle strength and balance around joints, and the use of
mobility aids.

Also helpful is occupational therapy to promote the performance of daily tasks
in a manner best for the joints. Lifestyle habits can also minimize and prevent
arthritis. Maintaining a healthy weight, for instance, can take the pressure off
of the joints.

Arthritis is a painful condition and one that most people don’t expect to
experience until they are elderly. Unfortunately for people with cerebral palsy,
the deterioration of joints that causes osteoarthritis begins early in life and
is more significant than for other people.

With good overall treatment, watching for early signs of arthritis, and treating
pain and other symptoms, a young person with arthritis can continue to enjoy
life with improved mobility and minimal pain.


LIFELONG FINANCIAL ASSISTANCE FOR YOUR CHILD'S BIRTH INJURYCEREBRAL PALSY

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REFERENCES

 1. What Is Arthritis? (n.d.). Arthritis Foundation | Symptoms Treatments |
    Prevention Tips | Pain Relief Advice.
    Retrieved from:
    https://arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis
 2. Emerging Issues in Cerebral Palsy Associated With Aging: A Physiatrist
    Perspective. (n.d.). PubMed Central (PMC). National Institutes of Health.
    Retrieved from:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637058/#b39-arm-2019-43-3-241
 3. Arthritis: Frequently Asked Questions (FAQs). (2019, February 21). Centers
    for Disease Control and Prevention.
    Retrieved from: https://www.cdc.gov/arthritis/basics/faqs.htm
 4. Juvenile ArthritisTypes and Treatments OrthoInfoAAOS. American Academy of
    Orthopaedic Surgeons. (n.d.).
    Retrieved from:
    https://orthoinfo.aaos.org/en/diseases--conditions/juvenile-arthritis/

View All References

PAGE MEDICALLY REVIEWED AND EDITED BY GINA JANSHESKI, M.D.

Gina Jansheski, M.D. is a Board Certified Pediatrician and a Fellow of the
American Academy of Pediatrics. She has been a practicing pediatrician for over
20 years, working primarily with hospitalized patients and children with special
needs.

See Full Bio


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