When a child who was running around yesterday suddenly limps, parents wonder what was hurt and whether to go in now. Causes range from minor to urgent, so the symptoms that come with the limp are what help you decide.
Why It Happens
The AAOS OrthoInfo page on the limping child says a limp is usually caused by a minor injury and often gets better by itself. Ill-fitting shoes, a splinter or foreign object in the foot, a bruise after a fall, and a muscle strain are common causes. Transient synovitis, a temporary hip inflammation that often follows a viral illness, is a frequent cause in young children and typically settles within about 3-7 days. At the other end are serious causes, including joint or bone infection (septic arthritis) and, rarely, tumors, which is why a doctor sometimes has to tell them apart.
How It Differs by Age
Babies and toddlers who have just started walking can’t tell you where it hurts. They may refuse to walk or cry hard when a diaper change moves the leg. Transient synovitis is known to be more common in the toddler-to-preschool years, while school-age children are more likely to limp from sports injuries or growth-plate problems. At any age, a fever or complete refusal to put weight on the leg calls for the same level of caution.
Care at Home
Take off shoes and socks and compare both legs from the sole, toes, and nails up through the ankle, knee, and thigh, looking for swelling, redness, warmth, or wounds. Watch your child walk and note how much weight goes on each leg. If pain is mild and there is no fever, you can reduce running and jumping for a day or two and watch how things change. Ask your doctor or pharmacist about pain medicine, since dosing depends on age and weight. Children’s Health Queensland advises seeing a doctor if the limp isn’t improving after 3 days or hasn’t resolved after 14 days, and OrthoInfo notes that limping lasting longer than 1 week, or getting worse, deserves medical attention.
Common Misunderstandings
First, assuming it is growing pains. Growing pains typically cause aching in both legs at night and are fine by day, which differs from a daytime limp on one side. Second, thinking there’s no problem because nothing looks swollen or bruised. Problems in deeper joints such as the hip may not show visible swelling. Third, being reassured because the child can walk a little. Kidshealth NZ says that if a child refuses to put any weight on a leg, this is not simply limping and needs to be seen urgently. Fourth, waiting at home because pain wakes the child at night but eases with medicine for a while. Children’s Health Queensland lists night pain, or pain that doesn’t settle with pain relievers, as a reason to see a doctor.
Signs That Need Emergency Care Right Away
Sources such as AboutKidsHealth advise going to the nearest emergency department if a limp comes with a fever, sudden or severe pain, or swelling or redness of the leg. Seek care right away too if the leg suddenly feels weak and can’t be moved, if your child won’t put any weight on it, or if a baby cries hard when the leg is touched during diaper changes. Septic joint infection is considered a medical emergency, so delay matters. If there is no fever but the limp lasts more than 3 days, or comes with night pain, tiredness, paleness, or weight loss, consider talking with your pediatrician. This information is general guidance; if you live outside the United States, check with a local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.