Leg pain in children

Definition

Leg pain that occurs in children is in most cases harmless growth pain. Nevertheless, the leg pain should be observed and, in case of doubt, clarified by a doctor.

Introduction

In general, it can be assumed that every third child has to deal with such 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.

Most often, leg pain in children is attributed to so-called growth pain as the bony skeleton grows, but its exact origin is not fully understood. Such pain typically occurs only in the evening/night and disappears completely in the course of the day. Persistent or recurring leg pain in children should, however, be urgently clarified by a paediatrician in case of doubt. The diagnosis is then made less by detecting growth pain and more by excluding other relevant causes.

Symptoms

Possible accompanying symptoms of leg pain in children can provide a decisive indication of the underlying disease. In the case of growth-related leg pain, the symptoms in children typically occur at night. In the case of leg pain that occurs during the day or under stress, growth-related pain can usually be ruled out.

The intensity of the leg pain varies greatly depending on the cause. In the case of growth-related leg pain in children, the intensity of pain is very variable. As a rule, affected children speak of a pulling, pressing pain that extends over the entire legs.

In comparison, leg pain that is so severe that the affected child can no longer walk can be an indication of a so-called “hip cold”. The location of the leg pain in children cannot be precisely indicated in the case of harmless leg pain. However, if a child can indicate a painful area very precisely, parents should mark this area with a pencil and consult a paediatrician as soon as possible.

In such cases, the leg pain should be clarified urgently. In addition, symptoms such as morning leg pain and joint stiffness are considered warning signals whose causes must be investigated. The same applies if the leg pain in children is accompanied by symptoms such as tiredness, paleness or fever.

If leg pain in children is accompanied by fever, it is possible that a bacterial or viral infection in the leg area is causing both symptoms. One of the most common causes in this case is hip rhinitis (coxitis fugax). This is described in more detail in the sub-item “Leg pain after an infection”.

If, in addition to the leg pain, swelling and reddening of the hip joint also occurs, a bacterial infection of the hip joint must be considered. The occurrence of leg pain together with fever is also a sign of a rheumatic disease in children under 16 years of age. Systemic arthritis (Morbus Still; a special form of rheumatic disease in children) shows the fever in a very special way.

It occurs over at least 2 weeks and then mainly in the morning and evening. This is how Still’s disease presents itself, especially in earlier phases. Later, the affected children mainly have joint problems.

If a child shows leg pain and fever in this way, the paediatrician should be consulted in order to rule out a rheumatic disease or to detect it early on. If children have abdominal pain and leg pain, then it should always be taken into consideration that the children indicate the abdominal pain because they simply cannot describe precisely enough where the pain is exactly. Small children like to report abdominal pain even though it is somewhere else.

Nevertheless, this pain should be taken seriously. A variety of illnesses can make themselves felt, such as leukaemia or systemic scleroderma. This is not the rule, however.

A doctor should be consulted if the symptoms persist or recur over a longer period of time. Another possibility, even in this constellation, can be a hip cold. The pain radiates from the inflamed hip joint into the stomach and legs.