Limp (Child)
Your child has a limp. This means they’re walking in an unsteady or uneven way, and not bearing weight on one leg. They’re limping because they have pain or weakness in their foot, leg, or hip.
Sometimes it’s fairly easy to know what’s causing a limp. In many cases, it’s from an injury. This can range from a broken bone (fracture) to a sprain (stretched or torn ligament) or a strain (pulled or torn muscle or tendon).
A child may also limp if they have a blister, cut, wart, splinter, or insect bite on their foot.
When there’s no injury or other obvious cause, it can be harder to know exactly why a child is limping. That’s especially true when a child is very young and can’t tell you what’s wrong.
A limp that occurs for no clear reason may go away on its own. Less commonly it may be a symptom of an underlying condition. These can include:
-
Toxic synovitis (transient synovitis). This is a very common cause of limping in children. It’s a temporary swelling (inflammation) of the hip joint that can be painful. It often occurs after a viral infection. It typically goes away in 1 or 2 weeks.
-
Juvenile idiopathic arthritis (JIA). Limping can be a sign of this type of arthritis that occurs mainly in toddlers and young children. A child with JIA often has morning joint stiffness that affects how they walk early in the day.
-
Infections. Sometimes a bacterial infection can get into a child’s bones and joints. This can lead to conditions such as:
-
Osteomyelitis.
-
Septic arthritis.
-
Developmental dysplasia of the hip (DDH). Some children are born with a dislocated hip. But this may not be found until a toddler limps as they start learning to walk.
-
Legg-Calve-Perthes disease. This hip condition mainly affects boys. It occurs when the upper end of the thighbone is damaged due to decreased blood flow.
-
Slipped capital femoral epiphysis. This is more common in teens. The growing part of the hip joint moves out of place. Surgery is usually needed to put the bone back in position.
Other less common causes of limping can include:
-
Severe belly (abdominal) pain, such as appendicitis.
-
Nervous system disorders such as cerebral palsy and muscular dystrophy.
-
Spinal disorders such as scoliosis.
-
Bone tumors.
-
Unequal leg lengths.
The health care provider has given your child a physical exam and taken their health history. They’ve also watched how your child walks and checked them for signs of infection. They may have taken X-rays of the hip, leg, or foot. The X-rays haven’t shown a fracture, sprain, or strain.
A specific cause of your child’s limp may have been found, or more testing may be needed. Your child may have been referred to a specialist.
Home care
General care
Use RICE (rest, ice, compression, and elevation):
-
Rest the leg for a few days.
-
Use ice to help control any swelling. Place an ice pack over the affected area for 15 to 20 minutes. Do this every 3 to 6 hours for the first 24 to 48 hours, or as directed. Keep using ice packs to ease pain and swelling as needed. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put an ice pack directly on the skin.
-
Compression devices can help to control swelling. These include dressings, bandages, and wraps.
-
Elevate (raise) the injured leg above the level of your child's heart as often as possible.
-
A child 1 year and older can prop their injured leg on a pillow while sitting or sleeping.
-
A baby younger than 12 months who is awake and observed can be placed on their side with the injured leg elevated. If your baby falls asleep, move them to a flat, firm surface. Never use pillows for sleep or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.
Medicine
-
The health care provider may prescribe medicines for pain and swelling. Or your child may use over-the-counter medicine such as nonsteroidal anti-inflammatory drugs (NSAIDs) as directed by the provider. Follow the provider’s instructions when giving these medicines to your child.
-
Always talk with the provider before using these medicines if your child has chronic liver or kidney disease, or has ever had a stomach ulcer or gastrointestinal bleeding.
-
Don't give aspirin to children or teens unless your child's provider says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.
Follow-up care
Follow up with your child’s health care provider, or as advised.
If X-rays were taken, you’ll be told of any new findings that may affect your child’s care. If you were advised to see a specialist, make that appointment now.
If your child's symptoms don’t get better or they get worse, talk with your child's provider. Your child may need blood tests, a repeat X-ray, or an MRI scan. They may need to see a pediatric bone doctor (pediatric orthopedist) for further evaluation.
Special note to parents
Health care providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several providers may ask questions about how your child was injured. Providers are required by law to ask you these questions. This is done for the child’s protection. Please try to be patient and not get upset with them.
When to get medical advice
Contact your child’s health care provider right away if:
-
The limp doesn’t get better, or it gets worse.
-
Your child can’t walk on the leg at all.
-
There is increasing pain or swelling in the leg.
-
The leg becomes red.
-
Your child has tingling, weakness, or loss of feeling in the leg.
-
Your child has a fever (see “Fever and children” below).
-
Your child has chills.
-
Your child has a rash.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
-
Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
-
Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
-
Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
-
Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
-
Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Below is when to call the health care provider if your child has a fever. Your child’s health care provider may give you different numbers. Follow their instructions.
When to call a health care provider about your child’s fever
For a baby under 3 months old:
-
First, ask your child’s health care provider how you should take the temperature.
-
Rectal or forehead: 100.4°F (38°C) or higher
-
Armpit: 99°F (37.2°C) or higher
-
A fever of ___________as advised by the provider
For a child age 3 months to 36 months (3 years):
-
Rectal or forehead: 102°F (38.9°C) or higher
-
Ear (only for use over age 6 months): 102°F (38.9°C) or higher
-
A fever of ___________ as advised by the provider
In these cases:
-
Armpit temperature of 103°F (39.4°C) or higher in a child of any age
-
Temperature of 104°F (40°C) or higher in a child of any age
-
A fever of ___________ as advised by the provider