Knee pain in children is a frequent concern for parents. This discomfort can stem from a variety of factors, ranging from common growth-related issues to activity-induced stresses.
Immediate Actions for Child Knee Pain
When a child experiences knee pain, home care can provide relief. The R.I.C.E. method (Rest, Ice, Compression, Elevation) is a common first-line treatment for minor soft-tissue injuries like sprains or strains. Resting the injured knee helps by avoiding activities that cause discomfort.
Applying ice to the affected area immediately can help reduce pain and inflammation. An ice pack, wrapped in a towel, should be applied for 15 to 20 minutes at a time.
Compression with a bandage, wrapped firmly but not too tightly, helps to minimize swelling and stabilize the joint. Signs a bandage is too tight include numbness, tingling, increased pain, coolness, or swelling below the wrap.
Elevating the injured knee above the level of the heart can reduce swelling by using gravity to drain fluid from the area. This can be done using pillows while the child is sitting or lying down.
Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can manage pain and reduce inflammation. Acetaminophen is generally safe for infants aged three months and older, while ibuprofen is typically not recommended for children under six months of age. Dosage should be based on weight or age, following product label instructions or consulting a doctor.
Recognizing When to Seek Professional Medical Help
While many instances of child knee pain can be managed at home, certain symptoms require medical evaluation. Parents should seek medical attention if the pain is severe or sudden, or if it causes limping or prevents weight-bearing. Any visible deformity in the knee joint warrants immediate assessment.
Serious signs of infection include increased pain, swelling, warmth, or redness around the knee, red streaks, pus draining from the area, or a fever. Consult a doctor if pain wakes the child at night, is not relieved by medication, or persists for over two weeks. Other concerns include a knee that feels unstable, locks, gives out, or has limited range of motion.
Understanding Common Causes of Child Knee Pain
Knee pain in children can arise from various common conditions, linked to growth and activity. One frequent complaint is “growing pains,” typically experienced by children aged 3 to 12. These pains are usually an aching or throbbing sensation in both legs, in the muscles of the thighs, calves, or behind the knees, and often occur in the evening or at night, resolving by morning. Despite their name, their exact origin is unknown, though they may relate to muscle aches from daily activity.
Osgood-Schlatter disease is another common cause, particularly in active children and adolescents. This condition involves painful inflammation where the patellar tendon attaches to the shin bone. It most commonly affects boys aged 10 to 15 and girls aged 10 to 13 during rapid growth spurts. Osgood-Schlatter disease is an overuse injury, often seen in sports with repetitive running, jumping, and squatting (e.g., basketball, soccer, volleyball).
Patellofemoral pain syndrome (PFPS), also known as “runner’s knee,” is a frequent source of pain at the front of the knee. This condition occurs when the kneecap does not move smoothly in its groove on the thigh bone, leading to irritation. PFPS is common in young athletes in activities with repetitive knee bending (e.g., running, jumping, climbing stairs). It can stem from overuse, muscle imbalances, or issues with kneecap alignment.
General overuse and minor sprains are prevalent causes of knee pain in children. Repetitive stress from physical activity can lead to injuries of soft tissues like ligaments and tendons, causing pain and swelling. This type of pain often develops gradually and can be managed with rest and activity modification.
Medical Evaluation and Treatment Options
When a child’s knee pain requires medical evaluation, healthcare providers typically begin with a history of symptoms and a physical examination of the knee. During this examination, the doctor may palpate the knee to identify tender areas, assess range of motion, and observe how the child walks, runs, or jumps.
Diagnostic imaging, including X-rays, might be used to rule out fractures or bony abnormalities. If soft tissue injuries like ligament tears or cartilage damage are suspected, MRI may be performed. MRI provides detailed images of soft tissues, bones, and cartilage to pinpoint the cause.
Treatment varies depending on the diagnosis. Many conditions respond well to conservative management. Physical therapy is a common recommendation, involving exercises to strengthen muscles and improve flexibility. A physical therapist can develop a customized program, including stretching and strengthening for the hips and thighs.
Activity modification is important, involving reducing or avoiding activities that worsen pain. For example, a child might switch from high-impact sports to lower-impact alternatives like swimming or cycling. Bracing or taping the knee can provide support and help with proper kneecap alignment, reducing pain during activity. In rare instances, for severe injuries like ligament tears or persistent kneecap instability, surgical intervention might be considered.