Childhood Musculoskeletal Pain


It’s almost here! Back to school time! But there’s something very important we parents need to know.

It is fairly common for children to complain of pain with the return to school and into the next few months. Whilst undoubtedly some aches and pains are what is termed ‘idiopathic growing pain’, it is important to distinguish this with actual musculoskeletal pain.

Pain can be confusing at the best of times let alone when children are involved. As fully qualified physiotherapists, Steve and Justin can help diagnose what’s the cause of your child’s pain.

‘Idiopathic growing pain’ is common between the ages of 3 and 12, frequently seen at night, and isn’t specific to a certain joint or muscle. It is normally present about the back of the knee, calf or front of the knee. It is not due to bone growth and has some links with genetic inheritance.

Specific musculoskeletal growth pain however can be related to rapid growth spurts seen in teenagers. It typically occurs during puberty when your child has a growth spurt and is also engaging in sport where there has been a rapid increase in the amount of exercise done over a short period of time – such as going back to school. It is very area specific. Common areas are the front of the knee, known as Osgood-Schlatter’s Syndrome, the base of the Achilles tendon where it meets the heel or the heel itself, known as Sever’s disease, and the front of the shins, known as shin splints.

Other specific exercise related childhood pain can be due to increased sport/physical activity, what we call ‘load’ in any age range. Similar to the above, it happens when your child’s body isn’t conditioned for the load after time off and so a body part becomes sore and achy. For these and the growth spurts pain outlined above, pain is typically worsened with sports/physical activity such as running, jumping, throwing or any other repeat movements. Areas of the body that are typically sore include the knee, shins, heel, Achilles tendon, kneecap, feet, shoulder, hips and back.

Both of these pain types can be easily treated after a comprehensive physiotherapy consultation where we can check to see if there are any muscle imbalances present. We will also then prescribe appropriate exercises, offer reassurance and advice regarding optimal loading whilst simultaneously guiding your child gradually back to their chosen sport/physical activity.

Other specific musculoskeletal pain in all child and teenage age ranges can also happen with return to school with the associated extra study and sitting times. This is commonly called ‘postural pain’ as it was thought to be due to a ‘bad’ posture. Thankfully, research has now shown there is no such thing as a bad posture, just a posture that isn’t right for you. Typical areas affected by this include the neck and back. Treatment and management involves a comprehensive physiotherapy consultation to see if there are any muscle imbalances present, advice regarding posture and breaks from painful postures, exercise prescription and reassurance.

Take home messages:

  • Be rest assured that although the above conditions can be quite debilitating for your child at the time, they will improve with the appropriate guidance.
  • Although rest from painful, aggravating activities are important, complete rest is not ideal and there are many things your child can still do whilst recovering from the above.