When a child complains of leg pain, is it a part of normal growth and development, or something more serious?
In short, is it “growing pains” or arthritis? It’s important to know the difference.
A child in preschool or kindergarten who complains of pain in the calf or thigh muscle or behind the knee typically has growing pains. Growing pains is a poorly understood condition of childhood. A child will typically complain of pain at bedtime that may last several minutes. The pain may be severe, but is typically self limited, meaning it resolves on its own. Treatments that seem to help include massaging the muscles, or giving a dose of Tylenol or ibuprofen. Growing pains can occur a few times per week. The key to diagnosing growing pains is that the child is otherwise healthy and is playing normally the next day. Worrisome symptoms that would suggest something other than growing pains would be back pain, fevers, weight loss, or persistent daily pain.
When a child develops stiffness, swelling, and pain in a joint that is persistent, that can be the presentation of arthritis. Children with arthritis are stiff in their movements especially after waking up in the morning or after a nap. You may notice stiffness after a long car ride. The stiffness can improve with activity and over the course of the day. Not all children with arthritis have joint pain and some may just have joint stiffness and swelling. A young child can also present with a limp. And if a child has persistent arthritis for more than six weeks, juvenile idiopathic arthritis (JIA) is a possibility.
Growing pains are very common among young children. And there is unfortunately no testing to diagnose growing pains other than the classic symptoms of self-limited nighttime pain seen in a child who otherwise has a normal, healthy physical exam. On the other hand, Arthritis is diagnosed based on morning stiffness and a physical exam that demonstrates joint swelling or stiffness. Other symptoms of arthritis can include joint warmth, redness, or pain.
In summary, a young healthy child with intermittent leg pains can be a normal phenomenon of childhood. Worrisome symptoms that need further investigation include joint swelling, joint stiffness, persistent pain, limp, or back pain. If your child complains of these, it’s time to visit your physician immediately.
By: Dr. Paul Rosen