Unfortunately, in many cases, doctors simply don’t know what such therapies do or might do, because many haven’t been well studied – particularly in children. Even therapies that are well accepted in adults may have completely different effects in children. Dr. Szer cites glucosamine and chondroitin as a possible example. Glucosamine is a substance that helps the body make cartilage. Among adults with osteoarthritis, it is one of the hottest remedies for pain relief. “But because children have growing bone, there is a notion that they could incorporate some of this glucosamine and into their bones and really create problems with bone integrity,” she says.

Another example is soy-based supplements that may contain plant-based estrogens (plant compounds with a chemical structure similar to that of estrogen) in them, says Kenneth Schikler, MD, professor of pediatrics and director of pediatric rheumatology and adolescent medicine in the department of pediatrics at the University of Louisville School of Medicine and Kosair Children’s Hospital in Louisville, Ky.

Although women may take soy supplements as a natural way to replace estrogen and combat post-menopausal bone loss, they aren't appropriate for bone loss that can occur in children with arthritis. Furthermore, estrogens can have negative effects on prepubertal children, he says.

The most dangerous therapy, however, is any one that is used to the exclusion of therapies prescribed by the doctor. If not treated properly, arthritis can cause permanent damage. Forgoing medications proven to help control arthritis with the hope or belief that an unproven therapy is all you need can waste precious time, says Dr. Szer.

Fortunately, among children seeing a pediatric rheumatologist, that problem isn’t too common, Dr. Szer suspects. A 2004 Canadian study supports her suspicion. It showed that while the use of complementary therapies was common in kids with arthritis, their use was not related to any decrease in adherence to conventional medical treatment.

“I think most families seeing pediatric rheumatologists don’t want to interfere with the medical management of their child’s disease,” Dr. Szer says. “Families are doing everything possible and looking at these alternatives because they only want the best for the child.”

Talking With Your Doctor

For many families, like the Zicklers, using complementary therapies can provide an increased sense of control over a disease characterized by an out of control immune system. Increasingly, such therapies are being studied, some with promising results, says Dr. Schikler, who is particularly interested in recent developments with fish oil supplements.

“In studies of fish oils in treating inflammatory arthritis, it certainly appears that it may have benefit with fewer potential side effects than nonsteroidal anti-inflammatory drugs,” he says. So far fish oils have been tested in adult RA, not in children. In fact, few complementary or alternative therapies have been studied in children. But Dr. Schikler keeps an open mind. “There are a lot of things that may be of value,” he says.