Signs of joint pain in children and when to see a doctor

Joint pain in children is very common and is often nothing to be concerned about. However, in a minority of cases, it can be a sign of an underlying condition that needs treatment. 

How to spot joint pain in children

Older children can usually tell you that part of their body hurts or aches. However, in young children who can’t communicate what they’re experiencing verbally, you’ll need to look out for signs of joint pain.

In young children who can walk, signs of lower limb joint pain may include limping, reverting back to crawling or sitting down more often. Signs of upper limb joint pain can be more subtle and harder to spot, such as keeping their arms close to their body or not fully using their arms when playing.

There are also more general symptoms of persistent joint pain in children, including poor sleep, loss of appetite, weight loss and not taking part in their usual activities as much.

Causes of joint pain in children

The causes of joint pain are numerous and varied. 

The vast majority of joint pain in children is non-pathological. Most often, joint pain in children settles down on its own within a week. Commonly, this type of joint pain is caused by a recent viral infection that causes inflammation within a joint (transient synovitis) and doesn’t usually need treatment. 

Joint pain in children can be from a very specific cause within that joint, such as a problem with the articular cartilage (osteochondritis dissecans) or trauma. 

There are also developmental issues that can occur, particularly with the hip joint. These can go unnoticed early in life but manifest in older children with pain and limping. 

Pain in multiple joints may be due to vitamin deficiencies, blood disorders or juvenile idiopathic arthritis (also known as juvenile rheumatoid arthritis). 

If you’re worried about your child’s joint pain, see your GP. Based on their symptoms and an examination, they may refer your child to a specialist such as a rheumatologist or an orthopaedic surgeon. 

When to see a doctor

Although in most cases, joint pain in children settles down on its own or with a good night's rest and a dose of paracetamol, if it persists you should see a doctor. 

Signs that your child’s joint pain needs further investigation include pain that is constant and lasts over 24 hours, pain that occurs frequently and/or affects your child’s ability to function for more than a week, and focal pain ie pain in a specific area (eg a toddler holding their shin or a teenager with elbow pain). 

Daytime pain is particularly significant as most children are distracted by mild pain in the day and are, therefore, unlikely to notice it or complain about it. If your child, therefore, does complain of joint pain in the daytime, it suggests that their pain is not mild. 

Other signs occurring alongside joint pain that indicate that your child’s joint pain should be investigated include fever, loss of appetite and redness around the affected joint. 

Treating joint pain

The treatment of joint pain in children depends on the underlying cause.

Often temporary joint pain can be relieved with rest, applying an ice pack to the affected joints, taking paracetamol and avoiding strenuous activities.

Specific conditions that cause knee joint pain in children need appropriate treatment. For example, if your child has osteochondritis dissecans (OCD), where the bone and cartilage inside a joint become diseased, surgery may be needed alongside lifestyle adaptations to better manage the condition.

A malformation of the knee, present from birth, where the meniscus is flat and disc-shaped (discoid meniscus) instead of C-shaped, can lead to meniscal tears. These are often repaired with surgery.

Problems with the patellofemoral joint of the knee, that is, the meeting of the kneecap (patella) and thigh bone (femur), are often complex and need long-term treatment, including lifestyle adaptations, physiotherapy and occasionally surgery.

If your child’s joint pain is caused by an underlying condition that needs targeted treatment, they will be referred to the appropriate specialist.