Limping in children is most often caused by physical injuries. However, prolonged limping without a physical injury may be a cause for concern. The causes of limping could range from a minor injury to an underlying medical condition. If limping in children is associated with pain, it should not be dismissed as growing pain since such pains never causes limping. Ice application, rest, or physical therapy can help manage limping caused by a physical injury. However, consult your child’s pediatrician if your child starts limping for no apparent reason. Read this post to know more about the causes, symptoms, diagnosis, and treatment of limping in children.
Symptoms Of Limping In A Child
While limping itself is a symptom of an injury or medical condition, it could be difficult to determine it in young children. Here are some symptoms that can accompany the limping.
Weakness or numbness in the legs or feet Pain in the hips Frequent falls Inability to sit for too long Complaints of pain in the back of the legs Inability to move the toes A lack of balance while walking
Once you have identified the symptoms, next, you need to understand why your child is limping.
Causes Of Limping In Children
The causes of limping in children may range from a simple physical injury to an underlying medical condition. Let us look at each one in detail.
1. Physical injury
This is a common cause of limping in children. If your child experienced physical trauma while playing and has started to limp, it could be due to gait deviations or a fracture or sprain in the hips, ankle, or legs. Your doctor will likely ask you the following questions to confirm if the limping is due to a fracture (1).
Did the child get up immediately after falling? When did the limping start? Does your child feel comfortable while crawling? Did you see any external injuries?
2. Irritable hip
Also known as transient synovitis, irritable hip is a common condition that causes hip pain and limping in children. It generally occurs due to the inflammation of the lining that covers the hip joint. The symptoms include pain and limited motion of the hip, and the condition is self-limiting (2).
3. Infections
Infections of the bone can also cause limping in children. One such infection is septic arthritis. The symptoms of septic arthritis are similar to that of irritable hip, so these two are often confused. Septic arthritis is characterized by a bacterial infection of the synovial joint and joint tissues. It mostly affects the hip and knee joints but could also affect the shoulder and ankle joints. Studies suggest that septic arthritis is mainly seen in children under the age of four. Along with the limping, a child with septic arthritis would also have a fever, joint pain, joint swelling, reluctance to walk on the affected limb, warmth around the affected joint, loss of appetite, and episodes of vomiting (3). Another type of bone infection caused by bacteria is osteomyelitis, which is characterized by inflammation of bone. The condition can also cause limping in children (4).
4. Juvenile arthritis
This is a condition found in children under 16 years. It is commonly characterized by the swelling of the joints and lymph nodes for up to six weeks. Although the exact cause is not known, the autoimmune disease is believed to be triggered by a combination of genetic factors, environmental factors, and a weak immune system. Juvenile arthritis is also characterized by limping, especially in the morning, high fever, skin rash, and clumsiness (5).
5. Legg-Calve-Perthes
Legg-Calve-Perthes (LCP) is a rare condition found in children aged five to seven years. It is characterized by painful limping and limited range of motion of the hip. It affects the femoral head, and the pain is often felt during physical activity. In some children, the pain might radiate into the thigh and knee (6). LCP occurs when the blood supply to the femoral head is temporarily disrupted. The revascularization(restoration of blood flow) may occur over two to four years if the child is under 12 years old at the onset of the disease (7).
6. Slipped capital femoral epiphysis (SCFE)
This is a condition that affects the hips of a child. In SCFE, the thigh bone ball slips off the thigh bone’s neck. Children might get this condition after a sudden fall or an injury. It is characterized by limping, pain that gets worse with activity, pain in the thigh, knee, and groins, and an outward-turned leg when they walk (8). Other medical conditions that can result in limping are:
Scoliosis, which is characterized by an abnormal curvature of the spine. This may cause the body to lean to one side, causing the child to limp.
Congenital disabilities of the hip, such as dislocated dysplasia of the hip. These can occur before birth or develop later.
Cerebral palsy. It is a condition that affects the nerves, causing the child to limp (2).
Acute leukemia. In rare cases, this could also be responsible for lower-limb pain and limping (9).
Diagnosis Of Limping
Based on the additional symptoms, your doctor might order the following tests to understand the reason behind the limping. Physical examination, X-rays, and ultrasounds may help determine if there is a fracture or a sprain in the legs that might be causing the limping. Two helpful tests that might help your doctor determine the cause behind the limping include (1)
Treatment For Limping In Children
Your doctor is the best person to evaluate the condition and suggest the best course of action. If it is a minor injury or an ankle sprain, the doctor might suggest restricting the movement, cold compresses, and elevating the injured leg. In the case of slipped upper femoral epiphysis, the child may need surgery as soon as possible. Your doctor may prescribe crutches to reduce the weight on the injured leg. Your doctor may also prescribe antibiotics for the treatment of infection. You can prevent certain causes such as injury and sprains by instructing your child to do regular stretching exercises before playing. You can also give them a nutritious diet so that their bones grow strong and healthy.
Experience sudden pain in their hip, thigh, or knee Cannot lift their weight on their legs Observe a change in the shape of their legs Experience severe pain in the lower abdomen Feel unwell, hot, and shivery Notice worsening of their symptoms.
However, if the pain continues along with fever, redness, and swelling, contact a doctor to know the possible cause (11).
