In children, hip pain is commonly due to a condition called irritable hip, which results in inflammation and discomfort in the hip joint.

Although it can be painful, irritable hip usually resolves on its own without causing any long-term problems.

More severe but less common causes of hip pain in children may include:

• Infection in the hip joint (septic arthritis)
• Injuries like fractures
• Conditions affecting hip bones and blood flow (Perthes’ disease)

These less common causes of hip pain in children are typically more concerning.

• Sudden pain in the hip, thigh, or knee
• Limping or inability to put weight on one leg

When diagnosing hip pain in children, a doctor might:

• Examine the hip, leg, or knee
• Move the leg gently in different directions
• Ask about recent injuries or illnesses
• Order an X-ray

Additional tests such as blood work or scans may be necessary for a complete diagnosis.

In most cases, irritable hip resolves within 1-2 weeks without causing any long-term issues.

For irritable hip, home care is usually sufficient:

Encourage the child to rest their leg until it heals

Attend follow-up appointments as recommended

Avoid activities that strain the hip for at least 2 weeks; swimming can aid in restoring joint mobility.

Received 2020 Jan 26; Revision requested 2020 Feb 16; Accepted 2020 Feb 20; Collection date 2020 Sep.

A study by the King’s Fund in 2010 revealed that GPs tended to refer younger children more often than older ones with similar needs, suggesting lower confidence levels and referral thresholds. Musculoskeletal issues account for about 30% of GP consultations, with a notable portion involving children.

Limping is a common reason for children visiting a GP and often leads to referrals to orthopedic services due to the range of potential diagnoses, some of which require immediate attention.

There are numerous reasons for limping in children, many of which are specific to certain age groups.

Common Conditions to Consider When Evaluating a Limping Child, Broken Down by Age

Accurate documentation of the developmental journey is vital when evaluating young children. It is important to recognize risk factors associated with conditions like developmental dysplasia of the hip (DDH).
### EXAMINATION
Examining a limping child can be complex, starting with observing their gait upon arrival:
#### Gait analysis
Distinguishing between normal and abnormal gait for the child’s age is crucial to determine the urgency of the situation. Different abnormal gaits can provide insight into the underlying issue.
An antalgic gait may indicate an acute problem, while other types could suggest a chronic condition.
#### Examination of the lower limbs
During the examination of lower limbs, focus on the hip, knee, and ankle using the ‘Look, Feel, and Move’ method. Keep an eye out for specific signs linked to chronic ailments such as Osgood–Schlatter disease or SCFE.
### WHEN TO REFER TO THE EMERGENCY DEPARTMENT
For immediate diagnoses, refer to the emergency department, and for chronic issues, seek the expertise of the pediatric orthopedic team.
In cases of trauma, septic arthritis, or suspected SCFE, urgent referral is crucial. Specific symptoms in children over 9 years old warrant immediate referral to the ED.
Children displaying red-flag symptoms associated with limping may require referrals to outpatient services like pediatric rheumatology or orthopedic services. Pediatric neurology referral may also be necessary for suspected neuromuscular conditions. A systematic approach is essential to rule out a septic joint and ensure appropriate referral.
Leg pain can vary in intensity and duration, ranging from acute to chronic. It can manifest as dull, sharp, burning, or tingling sensations, affecting different parts of the leg. Additional signs like swelling, sores, redness, or changes in color can also be present. Sudden, severe, or persistent leg pain should prompt medical attention.
Common causes of leg pain encompass cramps, injuries, infections, arthritis, nerve issues, and autoimmune disorders. Growing pains may be a contributing factor in children. Specific conditions such as compartment syndrome, fractures, ulcers, blood clots, varicose veins, and nerve problems can also result in leg pain.
Seek guidance from a healthcare professional for proper evaluation and management if experiencing chronic leg pain, joint problems, or growing pains in children.
### Key facts
– Various types of leg pain exist.
– Leg pain can manifest in specific locations or throughout the legs; as a sharp or dull sensation; feeling like burning or numbness.
– Treatment for leg pain is dependent on the underlying cause.
#### Muscle problems
– **Cramp**: sudden muscle contraction, often felt in the calf.
– **Muscle sprains and strains**: tenderness, restricted movement, muscle spasm, or swelling.
– **Compartment syndrome**: intense pain aggravated by leg movement, tingling, burning, numbness, pale skin, or coldness.
#### Infections
– **Ulcers, infected wounds, or blisters**: may cause a red, swollen, warm area accompanied by fever and malaise.
#### Problems with blood vessels or nerves
– **Blood clots or poor circulation**: swelling, tenderness, or paleness in the leg.
– **Varicose veins**: aching, throbbing, burning sensations in legs with swelling, darkened skin, and itching.
– **Claudication**: pain during physical activity, relieved by rest due to blocked arteries.
– **Nerve problems**: weakness, numbness, tingling due to diabetic neuropathy.
#### Other causes
– **Chronic conditions and joint issues** like rheumatoid arthritis, gout, or specific joint-related problems can lead to leg pain.
#### Growing
– **Growing pains in children**: muscle aches or burning sensation, typically at night.
### When should I see my doctor?
If your symptoms are causing anxiety or discomfort, it is advisable to consult with your doctor.
#### Provenance
Submission is voluntary; external peer review is conducted.
#### Discuss this article
Read and contribute comments about this article: [bjgp.org/letters](https://www.bjgp.org/letters)
### REFERENCES
1. Foot C, Naylor C, Imison C. The quality of GP diagnosis and referral. 2010 [Source](https://www.kingsfund.org.uk/sites/default/files/Diagnosis%20and%20referral.pdf) (accessed 31 Jul 2020).
2. NHS England Musculoskeletal conditions. [Source](https://www.england.nhs.uk/ourwork/clinical-policy/ltc/our-work-on-long-term-conditions/musculoskeletal) (accessed 31 Jul 2020).
3. National Audit Office Survey of general practitioners in England on the subject of autism. 2008 [Source](https://www.nao.org.uk/wp-content/uploads/2009/06/0809556_gp.pdf) (accessed 31 Jul 2020).
4. Krogstad P. Osteomyelitis and septic arthritis. Textbook of pediatric infectious diseases. 6th edn. Philadelphia, PA: Saunders; 2009.
5. Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 1999;81(12):1662–1670. doi: 10.2106/00004623-199912000-00002.
6. National Institute for Health and Care Excellence Clinical Knowledge Summary: acute childhood limp. 2015 [Source](https://cks.nice.org.uk/acute-childhood-limp#!scenario) (accessed 31 Jul 2020).
Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners
### Healthdirect Free Australian health advice you can count on.
healthdirect Australia is a free service where you can talk to a nurse or doctor who can assist you with knowing what to do.
### Leg pain
In some cases, leg pain can indicate a serious issue. Seek urgent medical attention if you experience sore or aching legs and display the following symptoms:
– Swelling.
– Deformity or impaired use of the legs.
– Unusually cool or pale legs.
– Numbness and weakness.
– Redness and warmth.
– Both legs are swollen with breathing difficulties.
– Pain worsening or appearing suddenly without explanation.
If signs of infection, such as fever, are present, seek medical advice promptly. Additionally, seek medical attention if experiencing calf pain after a long journey.
If the pain persists, your doctor may recommend consulting another healthcare professional. This could be a:
### How is leg pain treated?
Treatment for leg pain varies depending on the cause.
Sore or aching legs can often be managed at home. For individuals experiencing pins and needles, movement can help alleviate discomfort.
Gentle stretching of muscles may provide relief for muscle cramps. This applies to many other types of leg pain as well.
Simple pain relievers like paracetamol or anti-inflammatories such as ibuprofen can help alleviate discomfort.
In certain cases, medications like antibiotics or surgery may be necessary.
#### Treating leg pain from an injury
In the event of sudden pain from an injury, follow the RICER method:
– **Rest**: avoid moving the leg.
– **Ice**: apply an icepack or frozen peas for 15-20 minutes at a time. Ensure to protect the skin by wrapping them in a cloth. Repeat every 2 to 4 hours for 2 to 3 days.
– **Compression**: securely bandage the area, ensuring it is not too tight.
– **Elevation**: raise the leg above the hip.
– **Referral**: have the injury assessed by a doctor.
### Can leg pain be prevented?
Maintain overall health by ensuring adequate sleep, hydration, and regular exercise. Avoid smoking and aim for a healthy weight.
Select appropriate footwear for activities, replacing worn-out shoes. Prevent strains and injuries by warming up before exercise, cooling down, and stretching afterward. Gradually increase physical activity levels to avoid overexertion.
### Resources and support
For additional information on leg pain, contact the healthdirect helpline on 1800 022 222 (NURSE-ON-CALL in Victoria). A registered nurse is available 24/7.
**Source links:**
– Pain Specialists Australia (Leg pain)
– Pain Australia (Neuropathic leg pain)
– Brain and Spine Centre Sydney (Leg Pain)
*Last reviewed: November 2023*
### Related pages
– Calf pain
– Heel pain
– Muscle aches and pains
### Search our site for
– Leg
– Sprains and Strains
– Plantar Fasciitis
– Muscles
– Fibromyalgia
– Musculoskeletal System
– Muscle Cramp