A child living with a rheumatic disease does not necessarily have to live a limited lifestyle. All the members of the family are affected by a child's diagnosis of rheumatic disease. So everyone can do their part to make as normal a family life as possible. With the right management, a rheumatic disease may not have to interfere with your child's daily activities over a long period of time.

Exercise, when done the right way, can help reduce rheumatic disease symptoms. It does this by helping to:

• Prevent joint stiffness.
• Keep muscles strong around the joints.
• Improve joint flexibility.
• Reduce swelling.
• Reduce pain.
• Maintain strong and healthy bone and cartilage tissue.
• Improve joint alignment.
• Improve overall fitness.

Exercise is often an integral part of a child's overall treatment plan for pediatric arthritis or other rheumatic diseases. Exercise may also help with increasing your child's sense of well-being. There are three main types of exercises that may help children with rheumatic diseases:

• Range-of-motion. Range-of-motion exercises focus on moving the joints in certain directions to improve flexibility and reduce stiffness.
• Strengthening. Strengthening exercises help increase or maintain muscle strength around the joints, keeping joints more stable. Two common strengthening exercises include isometric (tightening muscles without using joints) and isotonic (strengthening muscles by using the joints).
• Fitness. Fitness exercises improve a child's endurance and cardiovascular health, while keeping muscles strong and joints more flexible. Types of fitness exercises that work best for most children with rheumatic diseases include walking, water exercise, and riding bikes.

Always talk with your child's doctor before starting any exercise program for your child. A physical therapist or an occupational therapist may be involved in your child's care to assist in exercise and therapy.

Researchers don't yet fully understand the role of diet and nutrition in rheumatic diseases. Studies are underway to examine the effects of food, weight, and nutrition on the disease. But the Arthritis Foundation recommends the following dietary guidelines for children with pediatric arthritis and other rheumatic diseases:

• Variety. Eating a variety of foods from the five food groups supplies your child's body with the nutrients it needs. Staying away from high fat, sugary, or processed foods may reduce inflammation. Fatigue, pain, and certain medicines may make it more difficult for a child with rheumatic disease to eat healthy.
• Weight. By helping your child maintain a healthy weight, there is reduced strain placed on their weight-bearing joints, such as the knees and hips. A nutritionist should be involved in managing your child's nutritional status.

Living with chronic pain and fatigue may leave your child feeling depressed and less able to cope with the pain. A cycle of pain, depression, and stress may keep a child from living their life to the fullest. Joining a support group for children and families with rheumatologic disease can often be helpful. Talk to your child's doctor about how to connect with a support group. Managing pain in a positive way and taking charge can help break such a cycle. Part of good pain management involves making sure your child is getting plenty of rest to preserve energy, including:

• Enough sleep. Sleeping 8 to 10 hours a night is important to maintain your child's energy level and restore their spirit. Sleep also allows the joints to rest. Sometimes, an afternoon nap helps give the joints a chance to rest.
• Relaxation. Being able to relax can help minimize the stress in your child's life and minimize symptoms. A relaxed body means the muscles are relaxed, relieving some of the pain associated with rheumatic disease. Many different relaxation methods exist. Talk with your child's doctor for more information.