Hip pain in children

Hip pain in a child may come from the hip joint, nearby muscles, or another part of the body. A child with a hip problem may instead report pain in the thigh or knee. Younger children may only limp, avoid walking, or become upset when their leg is moved.

Many cases follow a minor injury or a short-lived inflammation called transient synovitis. This is often called an irritable hip. However, irritable hip is one possible cause of hip pain, not another name for every type of hip pain.

A child’s age, recent illnesses, injuries, and ability to bear weight can help narrow down the cause. Hip pain with fever or an inability to stand or walk needs prompt medical assessment.

Your child may describe an ache or sharp pain in the groin, outer hip, buttock, thigh, or knee. Pain may be worse while walking, running, climbing stairs, or moving the leg.

A younger child may not be able to explain where it hurts. You may notice that they:

• Limp or walk differently
• Refuse to stand, crawl, or walk
• Hold one leg still or turned outward
• Avoid putting weight on one leg
• Cry during dressing, nappy changes, or movement
• Stop taking part in usual play or sport

Pain from the hip can sometimes be felt only at the knee. For this reason, a clinician may examine both areas even when the child points to just one.

Minor injury or overuse can follow a fall, awkward movement, running, jumping, or a change in sports activity. Muscle strains and bruises usually improve with rest and time.

Transient synovitis, or irritable hip, is temporary inflammation inside the hip joint. It often develops during or after a viral illness. The child may limp or refuse to walk but is usually otherwise reasonably well. Symptoms often begin improving within a few days.

Pain referred from another area may come from the knee, thigh, lower back, or abdomen. The place where pain is felt is not always where it began.

Less common causes include Perthes disease, in which the blood supply to the top of the thigh bone is temporarily disrupted, and juvenile idiopathic arthritis, which causes ongoing joint inflammation.

In older children and teenagers, a condition called slipped capital femoral epiphysis can affect the growth area at the top of the thigh bone. It may cause groin, thigh, or knee pain, a limp, and a foot that turns outward. It needs urgent assessment.

A joint or bone infection is another urgent possibility. It is more concerning when pain is severe or accompanied by fever, swelling, reduced movement, or an inability to bear weight.

Seek urgent same-day medical care if your child:

• Has hip or leg pain with fever
• Cannot stand or put weight on the leg
• Has severe or rapidly worsening pain
• Has a hot, swollen, or red joint
• Appears unusually sleepy, weak, or generally unwell
• Has new hip, thigh, or knee pain with an outward-turned leg

Go to an emergency department after a major injury if the leg looks deformed, appears shorter than usual, or becomes pale, cold, numb, or difficult to move.

Arrange a routine appointment if the pain or limp is not clearly improving after a few days, lasts about a week, keeps returning, or wakes your child from sleep. Your child should also be assessed if stiffness persists, normal activities remain limited, or you are unsure what caused the pain.

A clinician will ask when the problem started, where the pain is felt, and whether there was an injury, illness, fever, or change in activity. They may watch your child walk and examine the hips, knees, back, abdomen, and both legs.

Tests are not always needed when symptoms are mild and improving. Depending on the findings, tests may include X-rays, ultrasound, or blood tests for signs of inflammation or infection. An ultrasound can show fluid in the hip joint, but fluid alone does not identify its cause.

Early X-rays can look normal in some hip conditions. Persistent or worsening symptoms may therefore need repeat assessment or other imaging.

Treatment depends on the cause. If a clinician has advised that home care is suitable, encourage relative rest and avoid activities that increase pain. Do not force a child to walk on a painful leg.

A wrapped cold pack may help after a minor injury. Place it over the sore area for short periods and protect the skin with a cloth.

Paracetamol or ibuprofen may help with pain when appropriate for your child. Follow the product label and ask a pharmacist or clinician if you are unsure which medicine is suitable. Do not use pain relief to push a child back into sport before they can move comfortably.

Infections need prompt hospital treatment. Growth-plate problems, fractures, inflammatory arthritis, and Perthes disease may require specialist care. Follow any instructions about avoiding weight-bearing or using crutches.

Pain from a minor injury or irritable hip often begins to settle over several days. Irritable hip commonly clears within one to two weeks, although recovery time can differ.

Your child should gradually return to normal walking and movement. A worsening limp, new fever, increasing pain, or renewed difficulty bearing weight should be reassessed rather than watched at home.

Longer-lasting joint, bone, or growth-plate conditions have different recovery patterns. Follow-up helps monitor movement, comfort, and bone development.

Could knee pain come from the hip?

Yes. Hip problems can cause pain that is felt in the thigh or knee, sometimes without obvious hip pain.

Is this likely to be growing pains?

Typical growing pains affect the muscles of both legs, usually in the evening or at night. They do not normally cause joint swelling, daytime pain, or a limp. A child who limps should be assessed if it does not quickly resolve.

When can my child return to sport?

Wait until your child can walk, move the hip, and complete everyday activities without pain or a limp. Return gradually and follow any condition-specific advice.

Can irritable hip return?

It can happen again. Repeated episodes, persistent pain, or an ongoing limp should be reviewed to check for another cause.