Knee pain in children

Overview

Knee pain in children is a common complaint that can be caused by a variety of factors, from simple growing pains to injuries or conditions affecting the knee joint. In most cases, it is not serious and resolves with rest and simple home care.

Yes, knee pain is very common in children, especially during growth spurts and in those who are active in sports.

It can affect children of any age, but it is most common in active children aged 8 to 15 years, particularly those going through rapid growth.

Symptoms

Common symptoms

• Pain around the knee, especially after activity or at night.
• Swelling or puffiness around the knee.
• Stiffness, especially in the morning or after sitting for a long time.
• Limping or favoring one leg.

Symptoms in children

• Pain at the front of the knee just below the kneecap (often Osgood-Schlatter disease).
• Pain on the inside or outside of the knee (often related to growth or overuse).
• Complaints of the knee 'giving way' or catching.
• Pain that gets worse with running, jumping, or climbing stairs.

Symptoms in older adults

• This article focuses on children. Knee pain in older adults is a different topic.

Causes

Main causes

• Growing pains: harmless aches that often occur at night in the legs, including knees.
• Overuse injuries: from repetitive activities like running, jumping, or sports (e.g., Osgood-Schlatter disease, patellar tendinitis).
• Acute injury: sprains, strains, or fractures from a fall or twist.
• Patellofemoral pain syndrome: pain around the kneecap often from muscle imbalances.
• Juvenile idiopathic arthritis: a type of arthritis that can cause joint pain and swelling in children.
• Infection in the knee joint (septic arthritis) – rare but serious.

Risk factors

• Being very active in sports, especially those with running and jumping (e.g., football, basketball, gymnastics).
• Rapid growth spurts during puberty.
• Being overweight, which puts extra stress on the knees.
• Poor flexibility or muscle weakness around the knee.
• Wearing inappropriate or worn-out footwear.

When to see a doctor

See a doctor urgently if:

• If your child has severe pain, cannot bear weight, or has a visible deformity – go to the emergency department or call your local emergency number immediately.
• If there are signs of infection: redness, warmth, swelling, and fever – see a doctor urgently.

Book a routine appointment if:

• If your child has persistent knee pain that does not improve with rest and ice after a few days.
• If your child has a limp or avoids using the leg for more than a few days.
• If the pain returns regularly or interferes with daily activities or sleep.

Diagnosis

A doctor will ask about the pain, when it started, and what makes it better or worse. They will examine your child's knee, checking for swelling, tenderness, range of motion, and strength. They may ask your child to walk or do simple movements.

Tests that may be done

• X-rays: to look for fractures or bone problems.
• MRI scan: if the doctor suspects a soft tissue injury (like a ligament or cartilage problem).
• Blood tests: if there is concern about infection or arthritis.

What to expect at your appointment

The doctor will explain what they think is causing the pain and discuss next steps. Most often, no tests are needed and simple advice is given. If tests are done, they are usually quick and painless.

Treatment

Treatment for knee pain in children depends on the cause. Most cases can be managed at home with rest and simple care. Your doctor will recommend the best approach for your child.

Self-care at home

• Rest the knee by reducing or stopping activities that cause pain.
• Apply ice packs wrapped in a cloth for 15-20 minutes several times a day.
• Use a compression bandage to help reduce swelling (not too tight).
• Elevate the leg on pillows when resting to help with swelling.
• Give over-the-counter pain relievers like paracetamol or ibuprofen – always follow the dose instructions on the bottle or as advised by your doctor or pharmacist.

Medical treatments

If self-care is not enough, a doctor may recommend physiotherapy to strengthen the muscles around the knee and improve flexibility. In some cases, a brace or support may be advised. Anti-inflammatory medication may be prescribed for a short time. If there is an infection, treatment with antibiotics will be needed. Always follow your doctor's advice.

When is surgery considered?

Surgery is rarely needed for knee pain in children. It may be considered for serious fractures, certain ligament tears, or if other treatments have not helped. Your specialist will discuss this if needed.

Living with this condition

Most children can continue with normal activities, but they may need to modify or take breaks from sports or strenuous play until the pain resolves. Encourage your child to listen to their body and rest when it hurts.

Lifestyle tips

• Make sure your child wears well-fitting, supportive shoes for sports.
• Encourage a gradual warm-up and cool-down before and after activity.
• Teach your child proper technique for their sport to reduce strain on the knees.
• Maintain a healthy weight to reduce stress on the joints.

Diet and exercise

A balanced diet rich in calcium and vitamin D supports bone health. Low-impact exercises like swimming or cycling can help maintain fitness without stressing the knees. Always check with a doctor before starting a new exercise program.

Mental health and emotional wellbeing

Persistent pain can be frustrating and worrying for both children and parents. It may cause your child to miss school or activities, which can affect their mood. Talk to your child about their feelings and reassure them that most knee pain gets better. If you notice ongoing sadness or withdrawal, speak to your doctor.

Prevention

Not all knee pain can be prevented, but you can reduce the risk by encouraging proper warm-ups, stretching, and gradual increases in activity. Make sure your child uses appropriate gear and takes rest days.

Complications

If left untreated

• Persistent pain and limping that may affect daily life and participation in sports.
• Chronic overuse injuries that take longer to heal.
• Rarely, an untreated infection can lead to joint damage.

Long-term outlook

The outlook for children with knee pain is very good. With the right care, most children recover fully and return to their normal activities. Even conditions like Osgood-Schlatter disease usually resolve on their own as the child finishes growing. Working closely with your doctor will help manage any long-term issues.

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