The occasional bout of aching is normal in youngsters, and we often put it down to childhood ‘growing pains’. Children are generally robust creatures, and they will bounce back from injuries quicker than the average adult. But there are some conditions that affect youngsters, and such issues can become apparent as children return to school sports. So, as the new school year gets under way, we explain some of the more common bone and joint problems that we see in children.
1. Juvenile Idiopathic Arthritis (JIA)
This chronic autoimmune disorder affects children under 16 years of age. The exact cause is unknown, but it appears to involve a combination of genetic and environmental factors, and it affects more girls than boys.
JIA can affect many joints, or just one. There’s pain and stiffness, which are worse after rest (you may notice your child limping first thing in the morning). The child may also have a fever, rash and swollen lymph nodes (or ‘glands’).
JIA can interfere with growth, so seek advice if you have concerns. Treatment usually combines medication with physical therapy to help reduce inflammation and maximise the joint’s flexibility.
This is a common spinal disorder that is characterized by a side-to-side curve when viewed from the back. Again, there appears to be a genetic component to its development.
Scoliosis can cause back pain. In addition, nerve compression can lead to pain and tingling in the legs and feet. Changes to the shape of the ribcage and body cavities may compromise lung function and even digestion.
Look out for uneven waist or shoulders, a difference in the gap between waist and arm from one side to the other, and a prominence in the ribs on one side that’s most easily noticed as the child bends forward.
Many scolioses need nothing beyond a regular check to monitor progression. Bracing can be a useful option to prevent the curve increasing, and if severe, surgery may be appropriate. Physiotherapy or osteopathy can ease pain and improve function, and they can also help with post-surgical rehabilitation.
3. Osteochondritis dissecans (OCD)
If your child is experiencing pain, swelling and stiffness in a knee, elbow or ankle, and perhaps the joint feels weak, clicks or locks, then they may have osteochondritis dissecans.
Repetitive or high-impact injury to a joint triggers damage to the bone underlying the joint cartilage, due to a poor blood supply. This can lead to fragments breaking away, irritating the joint and causing stiffness and locking.
The condition may resolve with rest and physiotherapy. But in some cases, surgery to remove the fragment may be the best option.
4. Osgood-Schlatter disease
Teenagers and children with ‘growing pains’ at front of the knees may be experiencing Osgood-Schlatter disease. This common condition typically affects very active or sporty youngsters. The pull of the patellar tendon (just below the kneecap) on the still-growing bone at the top of the shin causes inflammation. Eventually, a bony prominence develops here.
Rest and ice are the first steps in treatment. A physiotherapist can assess the child’s biomechanics, to determine whether problems elsewhere are putting undue stress on the knee.
5. Perthes disease
This is a rare hip condition, affecting around 1 in 9000 children aged between three and eleven. A disruption of the blood supply to the head of the thigh bone (the ‘ball’ of the hip’s ball-and-socket joint) causes a portion of the bone to die. We don’t know the reason this happens.
The child may limp and have pain in the hip, groin or thigh when putting weight on the affected leg. The hip becomes stiff, and you may notice that the leg appears shorter than the other.
Eventually, the bone heals in most children, though the process may take two to five years. During this time, the bone is soft, so we recommend avoiding high-impact activities.
Once the child has a diagnosis, a physiotherapist can monitor the condition, and help maintain joint movement and muscle strength.
6. Scheuermann’s disease
Childhood ‘growing pains’ in the upper back may be due to Scheuermann’s disease. Typically seen in youngsters around 12 to 15 years of age, the condition causes a forward curve in the upper back. It happens because the vertebrae grow in a wedge-shape. As the child’s growth stops, so will the development of the curve.
The reason is unclear, although the condition seems to run in families.
Children with Scheuermann’s disease may complain of aching in the upper part of the back. If severe enough to affect the size of the chest cavity, it can affect lung and heart function.
A brace can help prevent the curve from worsening. In addition, physiotherapy can strengthen the back muscles and help mobility, which will ease pain and improve function.
Concerned about childhood ‘growing pains’?
Most childhood aches and pains are nothing to worry about. But if something more serious is going on, early identification can be key to a good outcome. If your child is complaining of any aches and pains, our osteopathy and physiotherapy team can help and advise you. Book online today.