Limping is quiet common complaint in many children. Since it is apparent, majority of parents seek medical attention as soon as they see their child walking abnormally. Limping can be described as laborious, uneven or jerky walk. At least 1 in 250 children limp due to various etiologies. The basic reason for limping can be due to pain, weakness of muscles or any structural deformity in bones.
Limping in children can be caused due to benign factor or life-threatening condition. The underlying cause of limping can be determined with proper physical examination and careful medical history.Often x-ray and radiological procedures are necessary for confirmation of clinical findings.
Treatment is to reassure parents if the cause is benign and temporary. However, sometimes corrective surgery may be needed if limping is due to deformity.
What Are The Various Causes Of Limping In Children?
There are several causes for limping in children. The problem can be minor or severe and life threatening.
- Injury is the most common cause for limping in children. Injury can occur usually while playing or running. It may be minor or serious.
- Fracture in leg bone is another form of injury that may cause limping.
- Leg sprain is also a type of injury that is common in children to cause abnormal gait.
- Infection in leg bone, joints, or in muscles and skin can cause pain and abnormal gait. Infection in most cases is bacterial. But sometimes viral infection in the leg tissues can also cause limping.
- Inflammatory conditions such as juvenile arthritis can cause pain, swelling and limping in children. It can occur in any joints, but often the knee and ankle joints are affected. Inflammation can also occur as a result of septic arthritis caused by bacterial infection in the knee joint.
There are few other causes of limping, but they are not as common as the above mentioned. They are as follows:
- Soft tissue tumor or bone tumor can cause pain and limping while walking.
- Legg-Perthes disease is a condition in which there is restricted blood supply to the hip joint. Without good blood circulation, the head of femur bone which is located in the socket of hip bone gets destroyed slowly. Although the condition is congenital, the symptom manifestation such as limping gait usually occurs between 4 and 10 years.
- Nervous system disorder can cause weakness or contraction in muscles which may precipitate limping as one of its symptoms. Cerebral palsy, muscular dystrophy can lead to limping gait.
- Structural deformity in leg bone or toe bones can cause limping. Rickets is one such bony disorder caused due to deficiency of vitamin D.
- Leukemia and lymphoma in children.
Associated Symptoms Of Limping In Children
Limping in itself is a symptom of a condition. There are several associated signs and symptoms that will help in clinical assessment of limping.
- Acute pain in leg and leg joint. This can be a sign of fracture of leg bone.
- Tenderness and discomfort.
- Swelling of the affected site.
- Associated back pain if the problem of limping arises from spine or from muscles of back.
- Fever, burning pain, weight loss, night sweats etc can occur due to infection such as septic arthritis of knee or ankle joint, malignant bone tumor and rheumatoid arthritis.
- Abnormal curvature of leg bone.
- Unusual spots on skin (rashes).
- Patient tries to put less pressure on foot.
Treatment Options For Limping In Children
Management of limping will depend on the underlying cause. In some cases treatment consists of medicines to alleviate pain and inflammation. If the child has muscle sprain apply ice fomentation for few days to treat the injury. Pain and inflammation can be controlled with anti inflammatory medicines, however, these medicines do have side effects hence it must be given as prescribed by the treating medical practitioner.
Support bandages and cast can be used to reduce swelling. It also helps to prevent any further injury. In case of fracture of bone, support bandage or cast may be used temporarily till the bone heals. Sometimes surgery may be needed if it is major fracture.
The child may require crutches to walk for a period of time to reduce strain on the affected leg. Limping caused by other conditions may need specific treatment for underlying pathology.