Musculoskeletal pain in children

Musculoskeletal Pain in Children

Musculoskeletal pain is a common complaint in childhood, sometimes very stubbornly, which disturbs the family and is among the most common reasons for referral to us.

The incidence of musculoskeletal pain in childhood varies between 10-30%. Although it is among the reasons for frequent referral to pediatric rheumatology specialists, only a very small part of the pain seen in children has an underlying disease. Most of the pain is benign.

One of the most common causes of benign musculoskeletal pain in children is musculoskeletal pain syndromes and growing pains.

Growing Pains

Occurs in 10-30% of children

It is the most common cause of musculoskeletal pain in children. The pain is intermittent and bilateral. It usually affects the front thigh and calf, but not the other limbs. The pain is usually more intense in the evening and at night. It goes away immediately with massage and painkillers. It can wake you from sleep. Growing pain never happens in the morning. The pain is benign and passes over time.

The parents of these children also have childhood musculoskeletal pain. The pain disappears from the joints over time. But in some of these children, the pain may change into different pains such as abdominal pain or headache.

Musculoskeletal Pain Syndromes

Although examination and laboratory findings are normal, it is characterized by persistent pain lasting longer than 3 months. The pain can be localized in a single limb, or it can be felt in several limbs at the same time.

Its incidence increases with age and is slightly more common in girls. Therefore, the most common age group is adolescent girls.

In addition to the complaints of pain in children with musculoskeletal syndrome pain, mental stress, sleep difficulties, dysfunction in home-school and functional work with peers. Psychological problems such as crying spells, fatigue, sleep disorders, feelings of worthlessness, poor concentration, frequent worry and anxiety are also common. Sometimes these children may also be diagnosed with major depression or generalized anxiety disorder.

Over time, these children begin to deteriorate in functional functions caused by pain, psychological stress, and sleep disorders. Reduction in school absenteeism, self-care or day-to-day care such as very basic household chores. Deterioration of relations with peers. Related loneliness and isolation are reported. These children have few friends and do not participate in extracurricular activities.

In a child with musculoskeletal pain, there is psychological stress, sleep disorder, and functional dysfunction along with pain, but if the examination and laboratory findings are normal in the evaluation made by the pediatrician, this pain should be evaluated as musculoskeletal pain syndrome.

What Are Other Possible Causes of Musculoskeletal Pain?

  • Trauma: falling, hitting, sprain, etc.
  • Childhood rheumatological diseases: Juvenile rheumatoid arthritis, acute rheumatic fever and many more rheumatic diseases
  • Reactive Arthritis: a benign form of arthritis that most commonly affects the hip joint after childhood upper respiratory tract infections
  • Childhood bone and joint tumors
  • childhood leukemias
  • Vitamin D deficiency
  • Infections that cause bone and joint pain, such as brucellosis

My Child Has Musculoskeletal Pain When Should I Be Worried?

  • If the pain is more intense in the morning
  • If there are additional complaints such as fever, abdominal pain, etc.
  • If there is restriction in joint movements such as limping while walking on the same leg with pain
  • If there is morning stiffness with pain
  • If there is a finding such as temperature increase, redness, swelling in the aching joint
  • If the pain does not respond to painkillers
  • If there is bone tenderness in the area of ​​pain
  • If there is growth retardation with pain
  • If there are symptoms such as extreme fatigue and weakness along with pain
  • If there is weight loss or excessive loss of appetite with pain

My Child Has Musculoskeletal Pain. When Should I Go to the Doctor?

Musculoskeletal pain in children should always be evaluated first by a pediatrician.

A systemic examination and necessary examinations should be performed to prove the origin of the pain from an innocent cause such as growing pain.

No musculoskeletal pain in children should be considered growing pain without proper evaluation.

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