Arm or Leg Pain

DEFINITION

  • Pains in the arms or legs (limb pain)
  • 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

WHEN TO CALL YOUR DOCTOR

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 over 12 hours
  • Bright red area on skin
  • Muscle weakness or can't stand or walk
  • Numbness (loss of sensation) present over 1 hour
  • Severe pain or cries when limb touched or moved

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) 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 over 7 days
  • Limb pains or muscle cramps 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

  1. 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 and sports drink in addition to stretching the muscle and a cold 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.
  2. Treatment For Strained Muscles From Excessive Use (Overuse):
    • 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 over 48 hours, have your child relax in a hot bath for 20 minutes twice a day, and gently exercise the involved part under water.
  3. 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.
  4. 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 over 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.

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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 7/15/2007

Last Revised: 8/5/2007

Content Set: Pediatric HouseCalls Online

Copyright 1994-2007 Barton D. Schmitt, M.D.
 
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