Musculoskeletal pain 

If your child has pain in their legs or arms, it could be musculoskeletal pain. This type of body pain affects bones, joints and muscles and can interfere with daily activities such as tying shoes or playing sports.

While it’s sometimes mistaken for typical growing pains – especially when it causes leg soreness at night – musculoskeletal pain may stem from an injury, disease or illness. Our pediatric orthopedic experts will help uncover the cause of musculoskeletal pain and support you every step of the way in your child’s care.

What is musculoskeletal pain?

The musculoskeletal system gives the body structure and support, allowing it to move. It includes bones, joints, muscles, tendons, cartilage, and ligaments.

Musculoskeletal pain occurs when any part of this system is affected by trauma. The pain may be mild or severe and can affect the whole body or just one area. An injury can cause sudden, acute pain, while an underlying musculoskeletal disorder, like a connective tissue disease, may result in chronic pain.

What causes musculoskeletal pain?

Musculoskeletal pain can have many causes, including:

• Injuries: Muscle or ligament tears, as well as broken bones, sprains, and dislocations.
• Medical conditions: Amplified musculoskeletal pain syndrome (AMPS), osteoporosis, rheumatoid arthritis, Lupus (SLE), or musculoskeletal cancers, including bone cancer and tumors.
• Musculoskeletal infections: Lyme disease and staph infections, including myositis, septic arthritis, or osteomyelitis.

Bad posture and muscle overuse may also lead to musculoskeletal pain, although this is more common in adults.

Symptoms of musculoskeletal pain

Musculoskeletal pain can be different for everyone, depending on the cause and location. One child may say they are feeling bone pain in a specific part of their body, while another child may simply avoid activities that make their pain worse.

Common symptoms of musculoskeletal pain include:

• Sharp or stabbing pain
• Dull ache
• Burning sensation
• Swelling or bruising
• Muscle twitching
• Stiffness

In babies and younger children, signs of pain aren’t always obvious. Children may show symptoms such as:

• Trouble sleeping
• Fatigue
• Avoiding walking
• Refusing to be held
• Loss of previously developed motor skills

How do you tell the difference between bone pain and muscle pain?

Bone pain often feels sharp, piercing or throbbing and seems to come from a specific spot deep within the bone. Muscle pain, on the other hand, is usually a sore, dull ache that feels more widespread.

Muscle pain usually gets better with rest, while bone pain often continues even with reduced activity.

Diagnosing musculoskeletal pain

To identify the cause of musculoskeletal pain, your doctor will first talk with your child about their symptoms, if they’re old enough or able to communicate. They’ll review your child's medical history, including previous injuries or conditions related to their bones, joints or muscles, and perform a physical exam, while ensuring they’re as comfortable as possible.

A range of tests is usually needed to confirm a diagnosis and rule out other possible causes of pain, including:

• Ultrasound: Reveals images of soft tissue
• X-rays: Creates a digital image of bones
• Magnetic resonance imaging (MRI): Provides detailed images of muscles, ligaments, tendons and cartilage
• Computed tomography (CT) scan: Creates 3D images of bones, fat, organs, and muscles
• Blood tests: Can confirm a condition or infection in the system

Musculoskeletal pain treatments

Your child’s doctor will determine the most appropriate treatment plan to help them feel better. If the pain is caused by an injury like a broken bone, they’ll focus on healing the injury while managing their orthopedic pain. If a medical condition is identified as the cause, your doctor may collaborate with other pediatric specialists to ensure comprehensive care for your child.

Other common treatments for musculoskeletal pain include:

• Applying ice or heat: To reduce swelling and relax muscles.
• Pain relievers: Your doctor may suggest over-the-counter medications like ibuprofen or acetaminophen to ease pain.
• Rest: Allowing the musculoskeletal system time to heal.
• Physical therapy: To improve strength, flexibility, and movement.
• Occupational therapy: To help improve fine motor skills, including self-care activities such as getting dressed.

Talk to your child’s doctor if they have new or worsening pain. Early attention can make a difference.