article icon

Limping in children

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

It's common for children to get minor injuries to the hip, leg, or foot that could cause them to limp – this might be a cut or bruise, a blister on their foot, or a muscle strain or sprain.

While limping is not usually anything serious or that needs treatment, it's important to look out for signs that something more serious is causing a limp, and get them to their doctor for a thorough assessment. A good starting point is whether there's an obvious injury – they might remember falling over or playing sports, or you may be able to see the cause.

Minor injuries will not cause other symptoms, so look out for any fever, excessive tiredness or inactivity, warmth or redness around a joint, or pain that's not improving after a week or so. Inflammatory conditions, deep infections, broken bones, or developmental problems are serious problems that need specialist input.

What are the causes?

If the child has a limp, the first thing to rule out is an injury. Check from hip to foot for any sprains and strains, bruising or cuts, and any objects stuck in the soles of the feet in case they have stepped on a sharp pin, splinter, or bit of glass. Check for blisters on the feet or in between the toes. And check that their shoes still fit them.

We'll talk through possible causes from the doctor's perspective, but if there's no obvious cause, this needs a doctor's examination, so there's no need for you to do the detective work yourself.

A recent viral infection can sometimes cause an irritable hip (or transient synovitis), where children usually aged 3 to 10 get a sudden pain in the hip, knee, or thigh, and this inflammation improves on its own. Young children can get a problem with bone formation called developmental dysplasia of the hip, causing long-term difficulty with movement and pain, and occasionally hip dislocation.

Perthes disease is where the blood supply to the head of the hip bone is cut off, causing pain in the groin, thigh, or knee after exercise, and feeling stiff in the hip.

Septic arthritis is a deep-seated infection in the hip joint, usually with an entry point for bacteria to get in, such as a cut or recent operation. Juvenile arthritis can be responsible for painful swollen joints that last longer than 6 weeks.

A broken bone, even if just a hairline fracture and your child doesn't recall a particular injury, can cause a limp – the pain will not be getting any better, they will have increasing difficulty putting their weight on the leg, and there may be bruising evident.

If you notice their leg turns inward and they suffer stiffness and pain in the groin, hip, or knee, this could be a problem with the top part of the thigh bone called slipped upper femoral epiphysis.

Osgood-Schlatter disease is a condition from overuse of the patellar tendon in older children, causing pain and swelling of the knee joint.

Cancer is rare in children but still a possibility, and a lump on your child's leg, weight loss, and pain at night may point to leukemia, lymphoma, or sarcoma.

When should I worry?

If there is no evidence of acute injury and your child is limping, this should be treated seriously, and your child should see a doctor right away. If the child is unwell with fever, vomiting, weight loss, or poor appetite, or the joint is red, hot, swollen, or there is an inability to put weight on it or move it, then the child needs to be examined urgently. You should head to your nearest emergency department for assessment.

It's cause for concern if there is an unexplained rash or bruising, unexplained lump, persistent infections, or pain that wakes the child at night. You may be able to get an urgent appointment with your doctor or go to the emergency department.

What will the doctor do?

The doctor will ask questions about the problem and their general health, to point to any particular cause. They will assess how your child is walking, and offer a physical examination of both legs and feet, including the joints. They may also look at the spine.

If an injury has been ruled out, further examinations and tests need to be done to look for other causes. Your doctor may do further tests such as a blood test, X-Rays, or further imaging such as an ultrasound, CT, or MRI scan.

Is there any medication that can be taken?

Pain should be managed with painkillers. Start with simple measures such as acetaminophen or ibuprofen. For injuries, it is advised to ice, elevate and rest the area. Blisters can be treated with blister plasters and by soaking the feet in warm salt water.

If it's something serious, the doctor can suggest appropriate painkillers and measures to take at home to aid comfort and recovery.

Was this helpful?

Was this helpful?

This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
App Store
Google Play
Piff tick
Version 2.26.4
© 2024 Healthwords Ltd. All Rights Reserved