Kids often complain of aches and pains: Tummies hurt, boo-boos bleed and limbs feel funny. As parents, it can be tough to know what’s going on.
Children’s perception of pain and their ability to communicate how they feel is different from adults, says UNC Health pediatrician Edward Pickens, MD.
“A child is not going to have the vocabulary or experience to describe what’s wrong the way an adult would,” he says. “They can’t say if a tummy ache is gas or constipation or if they got slugged in the stomach by their brother.”
If your child complains of pain or appears to be in pain, ask yourself these questions to get a fuller picture of what could be going on:
1. Does the pain come and go or is it constant?
If the pain is continuous—it doesn’t go away—you should check with your child’s doctor. Pains that pop up and then resolve on their own are probably nothing to worry about, Dr. Pickens says.
“Something serious is not likely to resolve on its own,” he says. “A headache that comes and goes is unlikely to be a brain tumor.”
Of course, just because a pain is persistent doesn’t mean it’s serious, either. An ongoing headache could be because of a sinus infection. But it does mean you’ll want to get a diagnosis and find your child some relief.
2. Does the pain move around or is it always in the same place?
Ask your child to point to where they hurt. Then ask again a bit later, especially if they complain of pain.
“If they point to different places, it’s probably not concerning,” Dr. Pickens says. “But if they point to the same place every time, that’s a sign we need to look into it.”
3. Is the child listless and quiet or running around and playing?
Even children who are sick or injured generally want to move and play.
“If a child says his tummy hurts, and he’s not interested in playing, that may be more significant than if he tells you he hurts but he’s still running around,” Dr. Pickens says. “If he’s running around, it doesn’t mean there’s no pain but it’s probably not bad.”
If your normally active child is unusually sedentary or clingy, call their doctor.
4. Do home treatments make it better?
If your child complains of pain, try over-the-counter medicine. Dr. Pickens recommends acetaminophen (Tylenol) for general aches and pains, including stomach pain.
“If their tummy or head or ear or anywhere aches, you can usually treat them at home and see what happens,” he says. “If Tylenol relieves the pain and it doesn’t come back when the medicine wears off, you probably don’t need to call the doctor.”
Of course, if the child has a high fever, is hard to rouse or is in severe pain, get emergency help, he says.
5. Does the arm, leg or joint still work?
If your child complains that their muscles or bones hurt, check for function, Dr. Pickens says.
“If a child says her arm hurts, but she’s still able to use it, then it’s not as concerning as if she’s not using it,” he says.
Even if a child doesn’t say that their arm or leg or foot or hand hurts, but they’re not using it, you should see what’s going on.
“Children will fool you,” he says. “They may not show as much pain as you think they would, but lo and behold, it’s a fracture. But, even if it doesn’t appear to hurt very much, you can tell that there’s a problem if they’re refusing to use an arm or refusing to walk.”
6. What else could it be?
Think about what the likeliest cause is for your child’s pain. It usually will be something common and not serious. For example, Dr. Pickens says, if a child hasn’t been injured, then aching or throbbing legs could be growing pains, “especially if it’s the middle of the night, and the pain is in the shins,” he says.
If the child has a cold and then starts to complain about ear pain, it could be an ear infection, which is a good reason to call your child’s doctor to see if antibiotics are needed. A sore throat is usually caused by a cold or virus, but if you suspect strep throat, you’ll need a test because strep must be treated with an antibiotic.
Abdominal pain might be constipation, diarrhea or something your child ate irritating their gastrointestinal tract. “Some of the worst abdominal pains I’ve seen turned out to be gas,” Dr. Pickens says. “But it’s hard to tell that pain from appendicitis in a young child,” so if the pain is persistent and located in the lower right quadrant of the belly, get it checked out right away. Appendicitis is an emergency.
7. What are you most concerned about?
Parents have particular concerns around health based on their own background, experiences and family history. Don’t be afraid to share that with your child’s doctor, Dr. Pickens says.
“There might be something the parent is already worried about,” he says, such as a family history of migraine, diabetes, asthma, cancer or another chronic condition.
“If we know what’s causing the concern, a lot of times we can provide some reassurance,” Dr. Pickens says.
If you have questions about your child’s health, talk to their doctor, or find one near you.