It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments

By Thomas J. A. Lehman | Go to book overview

4
The Child Who
Hurts All Over

Children who are not doing well or complain of constant pain are a source of great concern for both parents and physicians. Some parents are concerned that their child is not able to keep up with the other children when playing. Others are concerned about repeated athletic injuries, wondering why their child has so many sprains and strains. Still other parents are concerned that the child seems withdrawn, irritable, or has lost interest in activities. There are many possible explanations when a child is not doing well. They range from serious illnesses to problems adjusting at home or in school.

Most physicians who care for adolescents are aware that a dramatic change in behavior without obvious findings on examination might be a sign of drug use or depression, but it may also be the first indication of rheumatic or other serious diseases. Inability to keep up with other children may simply be an indication that the child in question is not athletic, but it can also be the first sign of many serious illnesses, including muscle weakness from dermatomyositis or arthritis due to any of its many causes. Repeated athletic injuries and recurrent tendonitis may be due to poor stretching techniques, but they may also be the first signs of a spondyloarthropathy that can be easily treated.

Because there are so many possible causes, children without an obvious explanation for their complaints often become a source of frustration. This frustration can be minimized if everyone agrees to take a systematic approach. Parents who are concerned that their child is not doing well should make a scheduled appointment with their physician for a full physical examination. It is best if the parents inform the physician’s office at the time

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