Limb Pain

Symptom Definition

• Pains in the arms or legs
• The pain is not due to a known injury
• Main Causes: muscle spasms and strained muscles from overuse (eg excessive throwing and jumping)
• Brief pains (1 to 15 minutes) are usually due to muscle spasms. Foot or calf muscles are especially prone to cramps that awaken from sleep
• Continuous acute pains (hours to 3 days) are usually due to overstrenuous activities or forgotten muscle injuries during the preceding day
• Serious causes: fractures or swollen joints (arthritis)

See More Appropriate Topic

• If follows injury, see Arm or Leg Trauma

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Swollen joint or can’t move joint fully
• Calf pain on 1 side lasts > 12 hours
• Bright red area on skin
• Muscle weakness or can’t stand or walk
• Tingling (pins and needles) sensation present > 1 hour
• Severe pain or cries when limb touched or moved

Call Your Doctor Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen
• Fever is present
• Pain makes child walk abnormally (has limp)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Cause of limb pain is uncertain
• Limb pain present > 7 days
• Limb pains are a recurrent problem

Parent Care at Home If

• Caused by muscle cramps in the calf or foot
• Caused by strained muscles
• 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
   • Massage the painful muscle with an ice pack for 20 minutes
   • If these are heat cramps (occurring during exercise on a hot day), give lots of water to drink in addition to stretching the muscle and an ice 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
2. Treatment For Strained Muscles
   • Massage the sore muscles with ice for 20 minutes several times on the first 2 days
   • Give acetaminophen or ibuprofen for pain relief
   • If stiffness persists > 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 > 7 days
   • Pain becomes worse
   • Your child becomes worse or develops any of the “Call Your Doctor” symptoms