It can awaken a child at night, or cause one to limp or toe-walk during the day. There are many possible causes for ankle and foot pain in children; some disappear on their own, while others require medical intervention.
These pains typically occur at night. Despite their name, they're linked to particularly active days rather than growth, according to the American Academy of Pediatrics (AAP). While more common in the legs, growing pains can present themselves in feet. The pain usually subsides with rubbing/massage, a heating pad, and/or over-the-counter pain relievers (ibuprofen or acetaminophen).
The AAP advises seeking medial advice for "growing pains" if a child experiences persistent pain, pain in the morning or swelling, tenderness and redness in a joint; joint pain associated with an injury; or limping, weakness, or unusual tiredness.
Toe-walking among toddlers learning to walk is common and can cause a tight or painful Achilles tendon or heel pain. When older toddlers and children walk on their tip-toes, parents should consult a pediatrician as it might result from a shortened Achilles tendon or be a symptom of an underlying neuromuscular problem (i.e., muscular dystrophy or cerebral palsy).
Flat feet, in which the feet don't have normal arches, are common among children; most will out grow them. Flat feet aren't usually problematic; however, they can cause foot or ankle pain in older children after excessive walking or running. A podiatrist can recommend a heel cup or shoe insert.
Injuries and Infections
Stress fractures most often occur in adolescents engaged in athletic activities. These are usually easy to diagnose, as the pain most often sets in immediately following the injury and is accompanied by swelling and redness.
Severe's Disease---an injury, not an illness---is a common cause of heel pain in children ages 8 to 12 (early puberty). During weight-bearing activities, heel tendons may put too much pressure at the back of the heel, injuring it. Treatment includes icing the heel(s) and refraining from the activity that caused the injury for a few weeks to a few months.
Infections of the bone or joints usually are caused by blood-borne infections---by stepping on an infected surface with a cut foot, for example---and can cause pain, swelling, redness and painful, limited joint movement. These types of infections are very dangerous, so immediate medical attention is required.
Complex Regional Pain Syndrome (CRPS)
A chronic condition, CRPS presents a continuous, intense pain---burning, skin sensitivity, sweating and swelling---following an injury. Rather than subsiding as the injury heals, the pain gets worse over time. CRPS usually affects a foot or hand, and then spreads to the leg or arm. Researchers haven't determined what causes CRPS. Some believe the sympathetic nervous system plays an important role in sustaining the pain; others think it is triggered by an immune response.
Foot or ankle pain may be completely benign, or a symptom of something serious. Therefore, it's important to seek medical advice whenever your child suffers from new, or prolonged, foot or ankle pain to obtain a proper diagnosis and, if necessary, a treatment plan.
- Caring for Your Baby and Young Child: Birth to Age 5, The American Academy of Pediatrics (2004)
- Foot Physicians' guide to pediatric foot pain
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