ARM OR LEG (LIMB) PAIN
Symptom Definition
- Pains in the arms or legs
- The pain is not due to a known injury
- Minor muscle strain and overuse are covered in this guideline
Causes
- Main Causes: Muscle spasms (cramps) and strained muscles from overuse (e.g., excessive throwing or jumping)
- Muscle Cramps: Brief pains (1 to 15 minutes) are usually due to muscle spasms (cramps). Foot or calf muscles are especially prone to cramps that occur during exercise or that awaken your child from sleep.
- Strained Muscles: Continuous acute pains (hours to 3 days) are usually due to overstrenuous activities or forgotten muscle injuries during the preceding day. Can occur in arms or legs.
- Growing Pains: 10% of healthy children have intermittent, harmless leg pains that are often referred to as "growing pains" (although they have nothing to do with growth).
- Viral Infections: Muscle aches are common with viral illness, especially influenza.
- Serious Causes: Fractures or swollen joints (arthritis)
See More Appropriate Topic (instead of this one) If
- Follows injury, see ARM INJURY OR LEG INJURY.
WHEN TO CALL YOUR DOCTOR FOR ARM OR LEG (LIMB) PAIN
Call 911 Now (your child may need an ambulance) If
- Not moving or too weak to stand
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Swollen joint
- Calf pain on 1 side lasts more than 12 hours
- Bright red area on skin
- Muscle weakness or can't stand or walk
- Numbness (loss of sensation) present more than 1 hour
- Severe pain or cries when limb touched or moved
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
- You think your child needs to be seen
- Fever is present
- Pain makes child walk abnormally (has limp)
- Painful joint and can’t move it normally
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Cause of limb pain is uncertain
- Limb pain present longer than 7 days
- Limb pains are a recurrent ongoing problem
Parent Care at Home If
- Caused by muscle cramps in the calf or foot.
- Caused by strained muscles from excessive use.
- Cause is obvious and harmless (e.g., tight new shoes, a shot within last 24 hours).
HOME CARE ADVICE FOR MUSCLE CRAMPS OR MUSCLE STRAINS
- Treatment For Muscle
Cramps:
- Muscle cramps in the feet or calf muscles occur in a third of children.
- During attacks, stretch the painful muscle by pulling the foot and toes upward as far as they will go to break the spasm.
- Stretch the muscle in the direction opposite to how it is being pulled by the cramp or spasm.
- Apply a cold pack or ice bag wrapped in a wet cloth to the painful muscle for 20 minutes.
- If these are heat cramps (occurring during exercise on a hot day), give lots of water to drink in addition to stretching the muscle and an ice pack.
- Future attacks may be prevented by daily stretching exercises of the heel cords (stand with the knees straight and stretch the ankles by leaning forward against a wall). Also give the feet more room to move at night by placing a pillow under the covers at the foot of the bed. Also be sure your child gets enough calcium in the diet.
- Treatment For Strained
Muscles From Excessive Use:
- Apply a cold pack or ice bag wrapped in a wet cloth to the sore muscles for 20 minutes several times on the first 2 days.
- Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief.
- If stiffness persists more than 48 hours, have your child relax in a hot bath for 20 minutes twice a day, and gently exercise the involved part under water.
- Expected Course: Muscle cramps usually last 5 to 30 minutes. Once they resolve, the muscle returns to normal quickly. A strained muscle hurts for 2 or 3 days. The pain often peaks on day 2.
- Call Your Doctor If:
- Muscle cramps occur more frequently
- Child develops a limp, a swollen joint, or a fever
- Pain caused by work or exercise persists longer than 7 days
- Pain becomes worse
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Godley DR. A practical approach to the child who limps. Contemp Pediatr. 2002;19(2):56-63.
- Inocencio JD. Musculoskeletal pain in primary pediatric care: Analysis of 1000 consecutive general pediatric clinic visits. Pediatrics. 1998;102(6). URL: http://www.pediatrics.org/cgi/content/full/102/6/e63.
- Leung AKC, et al. Leg cramps in children. Clin Pediatr. 1997; 36:69-73.
- Metzl JD, Metzl JA. Shin pain in an adolescent soccer player: a case-based look at "shin splints". Contemp Pediatr. 2004;21(9):36-47.
- Renshaw T. The child who has a limp. Pediatr Rev. 1995;16:458-465.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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