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Thursday, April 17, 2014
Leg pain in 3-year-old
My son will be 4 in January. For a couple of years, he has occasionally cried in the middle of the night that his "feet" hurt. When he was younger, he was unable to point to the pain. Now he says that his "leg" hurts, and the last couple of times has pointed to the back of his left knee. He is large (at least 45 pounds, 40 inches tall) and has flat feet. He is healthy. I have asked our pediatrician about this multiple times. The dr. has checked his hips and done blood tests (for arthritis and leukemia, I believe), all negative. Could this pain be growing pains? Should I seek out additional professional advice?
Pain in the lower extremities, especially the legs, is very common in the older toddler and younger school aged child. Although it is often called "growing pain" we do not actually know what causes it. It usually is only a problem at night, and may be uncomfortable enough to cause the child to cry. It often responds to ibubrofen, acetaminophen, or gently massage.
As far as the diagnostic work up, it may be appropriate in some cases to check an Xray, but if the pain is mild and self limited ,we will often recommend observation. There are a few conditions to consider, including arthritis and diseases of the bone. These can be in part assessed through blood tests.
We are only in a position to answer general medical questions, and not address specific diagnosis. If you remain uncertain about the diagnosis, we recommend addressing this in an honest way with your pediatrician, especially mentioning the fact that this condition is still a great cause of concern for you.
Caroline Mueller, MD
College of Medicine
University of Cincinnati