Causes
The possible causes for the occurrence of leg pain in children range from harmless growth pains to malignant tumours. Depending on when the pain occurs, different causes can be considered. Growth pain is one of the most common causes of leg pain in children that occurs at night.
In general, it can be assumed that one in three children will experience this type of leg pain at some point. The majority of children suffer from growth-related complaints between the ages of two and three. In addition, leg pain can often be observed in children of primary school age.
An important indication that the leg pain is merely a harmless growth pain is that the symptoms cannot be localised exactly. In addition, the pain often changes from one leg to the other. Exactly which mechanism provokes these growth pains is still unclear.
However, experts assume that various growth hormones, which are mainly released at night, are associated with this type of leg pain. The growth hormones induce an acceleration of growth in the organism, as a result of which the sensitive bone skins can be stretched and irritated considerably. In this case, the affected child feels tension-like leg pain.
In addition, it is being discussed whether incorrect posture and excessive strain on the musculoskeletal system favour the development of growth-related leg pain in children. Persistent or recurring leg pain in children should, however, in case of doubt, be urgently clarified by a specialist in paediatrics. The diagnosis is then made not so much by detecting growth-related pain but rather by excluding other relevant causes.
If leg pain occurs mainly at night, a so-called “osteoid osteoma” may be present. An osteoid osteoma is a benign bone tumour. In addition, malignant changes in the bones can also lead to leg pain in children.
A classic example of a tumour relevant in this context is the so-called “Ewing sarcoma“. Ewing’s sarcoma mainly affects the pelvic or thigh bones and is considered the second most common bone cancer in children. Another harmless cause of leg pain in children is muscle soreness caused by high stress.
In this case, the symptoms typically occur in the morning after the causal strain and continue during the day. After a traumatic event, such as a fall or accident, the cause of leg pain in children can also be a broken bone or joint injury. In addition, injuries to tendons, ligaments or muscles are among the most common causes of leg pain in children that persist during the day.
Other causes of persistent leg pain in children during the day can be bone necrosis. Typical examples of such skeletal changes are Legg-Calvé-Perthes disease or Osgood-Schlatter disease. Leg pain, which occurs particularly in the morning, should be examined more closely.
This is not a typical time for growth pain. Complaints occurring in the morning, such as stiffness and pain, are possible signs of a childhood rheumatic disease. This affects the large joints in the legs, such as the hips and knees.
Especially in the morning it takes a while until the child is free of pain and can move properly. If symptoms of this kind and others such as fatigue or exhaustion occur, it should be discussed with the paediatrician whether a blood sample should be taken to check inflammation markers and rheumatoid factors. An inflammation (arthritis) of the joints in children can also be caused by Lyme disease.
Borrelia are tiny bacteria that are transmitted by ticks in many places. The arthritis is not the first symptom, but a sign which appears after weeks or months. Due to the late occurrence, parents often do not even think about whether or when the child has had a tick.
The diagnosis can be confirmed by a serological blood test for Borrelia antibodies and then treated with an antibiotic. The main cause for the occurrence of leg pain in children is the so-called growth pain. However, if the pain only occurs depending on the load, or increases significantly in intensity after loading, the growth pain can usually be excluded and other causes requiring treatment must also be considered.
If the pain occurs after an accident or fall, traumatic changes in the muscles, tendons, joints or bones must be considered. It could be a broken bone or just a harmless muscle ache. Another condition that can often lead to severe leg pain in children is leukemia.
Children who suffer from blood cancer often report severe pain in their legs. The symptoms also occur at rest, but worsen drastically under stress, making even walking almost impossible. If the symptoms of the disease are such that the children concerned must be urgently presented to a pediatrician as soon as possible.
Stress related leg pain in children is not unusual. One of the most common causes is simple muscle ache. The child has exerted himself and accordingly the muscles are painful.
Furthermore, it is possible that the child has developed a slight bruise somewhere on the leg while playing, which now causes pain. If the leg is examined, this bruise would be noticeable by bruising, swelling and pain from pressure. LIn case of leg pain in children after an expired infection in the respiratory or gastrointestinal tract, it is important to rule out an inflammation of the hip joint.
Colloquially, the so-called hip rhinitis is also often spoken about. In most cases children have a simple viral infection of the upper respiratory tract. After approx.
1-2 weeks, the children experience pain in the hip and knee area:The strain on the leg is often painful for children. The mobility in the hip joint is limited. Especially the internal rotation in the hip is significantly reduced.
The children like to adopt a gentle position of the hip. In doing so, the hip is bent and kept in external rotation, as this is the way to minimise the pressure on the inflamed hip joint. The complaints are caused by an inflammation-related effusion (fluid) in the hip joint.
The therapy consists of immobilising the legs and, if necessary, also ibuprofen or paracetamol. After approx. 1 week the complaints should have disappeared.
However, if the problem should still be present after 2 weeks, then one must think of a bacterial inflammation of the hip joint causing the leg pain. This occurs directly, e.g. after an unsterile joint puncture or by haematogenous means, for example through gonococci or borrelia bacteria that enter the joint. However, bacterial inflammation of the hip joint is not usually preceded by an infection.
Persistent intense leg pain in children, which worsens under stress and makes walking almost impossible, may possibly be related to leukaemia (blood cancer). In addition to the leg pain, children suffering from leukaemia often notice general symptoms such as fatigue, tiredness, weight loss, bleeding tendency and increased susceptibility to infection. In addition, affected children often show increased bruising.
The term leukaemia refers to a group of cancers of the haematopoietic system. Leukaemia is a malignant disease of the bone marrow. In the course of the disease, too many, usually immature and therefore non-functional white blood cells (leukocytes) are produced in the bone marrow.
These then displace both healthy white blood cells and mature red blood cells. The term leukaemia means freely translated “white blood”. Basically four forms of leukaemia must be distinguished.
The chronic forms, chronic myelogenous leukaemia (CML) and chronic lymphatic leukaemia (CLL), as well as acute myelogenous leukaemia (AML) can be observed mainly in adults and the elderly. In contrast, acute lymphatic leukaemia (ALL) occurs mainly in children under the age of five. Affected children typically suffer from leg pain, enlarged lymph nodes, bleeding and conspicuously frequent infections.
The prognosis of ALL depends on various factors. If this form of leukaemia occurs in children, around 80 percent of those affected are still alive five years after treatment. Growth pain is mostly leg pain, but in rare cases it can also affect the hands or arms.
Growth pain typically occurs in the evening or during the night. The cause of growth pain is a stretching of the periosteum. This is particularly sensitive and painful because the bone grows faster than the periosteum which surrounds the bone on the outside.
Another typical symptom of growth pain is that children often cannot localise the pain precisely. Growth pains also have the habit of being able to change sides. In addition, growth pain typically occurs in pre-school age, i.e. between the ages of five and six in children.
Perthes disease is a disease of the femoral head that usually occurs around the time a child starts school. The reduced blood flow to the femoral head causes it to collapse. However, the clinical picture also includes the fact that the femoral head rebuilds itself independently.
In this clinical picture, children typically complain of pain in the hip and knee. In addition, the children feel severe pain when they sit cross-legged. When rebuilding the femoral head, however, care must be taken to ensure that it grows back together in the right shape and in the right place.
If this is not the case, conservative or, if necessary, surgical therapy must be used. Sinding-Larson-Johansson’s disease, or patellar tendon syndrome, is an overloading of the hamstring, which leads to a painful, and in the worst case permanent, inflammation. The site of the event is a tendon which is attached to the shinbone, surrounding the kneecap.
Excessive traction or compression may cause the kneecap, tendon and bone to rub against each other, which initially causes painful irritation. If the irritation is permanent, a chronic inflammation can develop. The disease often develops as a result of sporting overloading or incorrect loading.
As a rule, therapy includes physical rest with complementary physical applications. You can find more information on this topic here:
Patellar tip syndrome. Osgood-Schlatter’s disease is an inflammatory reaction of the hamstring tendon, which occurs particularly frequently in adolescents in early puberty.
Overexertion during sport causes irritation at the point where the tendon attaches to the shin bone. The inflammatory reaction can also cause small pieces of bone to come loose, which then die off. Often the affected persons complain about pain at the beginning only when under stress.
However, if the disease is not treated, the pain can also occur at rest. Usually it occurs only on one side, but can also affect both sides. Osgood-Schlatter’s disease is usually treated with physical rest, if necessary also with anti-inflammatory medication.
Surgery is only necessary in rare cases. Osteomyelitis is the technical term for a so-called bone marrow inflammation. It is usually caused by the introduction of various pathogens during open fractures or operations on the corresponding bone.
As a rule, not only the marrow is inflamed, but also the remaining bone and the associated periosteum. What is rare in adults, however, is much more common in children: Pathogens colonize the bone marrow via the blood, i.e. without direct contact of the bone with the external environment. Due to the still open growth gaps, bacteria can also enter the bone directly from the blood in children and thus attack the bone marrow.
Inflammation of the bone marrow usually manifests itself with diffuse pain that cannot be localized exactly. In this case, imaging procedures such as X-rays or subsequent MRI can help. Bone tumours occur relatively more frequently in children than in adults.
Many bone tumours peak in frequency between the first and second decade of life. Fortunately, not all bone tumours are malignant, but tend to be benign. The form of the pain as well as its localisation is of course strongly dependent on the type of bone tumour from which the child is suffering.
Therapy for benign and malignant bone tumours differs greatly. While surgical removal is usually sufficient for benign tumours, malignant bone tumours are usually treated with radiotherapy and chemotherapy. The prognosis of a child’s bone tumor disease is of course always dependent on whether the tumor is benign or malignant, when the tumor is discovered; means how far tumor growth has progressed and many other things.
In general, however, medicine has moved away from giving approximate survival periods as prognoses. Instead, one works with percentages that are still alive after five years, for example. Malignant bone tumours, for example, also have a five-year survival rate of just over 50%. An early diagnosis and good response to treatment naturally improves the chances of survival. Inflammation of joints Bow legs or bow legs Scoliosis Flexion foot Rheumatism Gout Circulatory disorders Hip cold Fibromyalgia
- Joint inflammation
- Knock knees or bow legs
- Scoliosis
- Snap foot
- Rheumatism
- Gout
- Circulatory disorders
- Hip Fever
- Fibromyalgia
- Polyneuropathy
