Painful Joints
15CHAPTER
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Joint pain in children has many causes. Depending on the cause, different treatments
may be needed. The chart that follows will help you decide what the cause of chronic
(long-lasting) joint pain in a child might be. However, other less common causes may
also be possible. Sometimes laboratory tests may be needed to be more certain.
Specific treatment is needed for certain kinds of joint pain—especially those caused
by infection. However, some basic principles of care and therapy apply to most joint
pain, regardless of the cause. Following the chart of causes, you will find some general
guidelines for the care of joint pain. These guidelines are described in more detail in
Chapter 16 on juvenile arthritis.
Three chapters on disabilities with joint pain are “Juvenile Arthritis” (Chapter 16),
“Rheumatic Fever” (Chapter 17), and “Hip Problems” (Chapter 18). However, arthritis
(joint pain and damage) can occur with any disability where paralysis or muscle
imbalance cause abnormal positions or twisting of joints. Many children with polio
develop painful dislocations or, when they are older, arthritis.
NOTE: The chart does not include the many infectious diseases that may cause
temporary joint pain. These do not usually lead to long-term disabilities. For details of
diagnosis and treatment of illnesses that cause temporary joint pain, consult a health
worker or see a medical text such as Where There Is No Doctor.
CAUTION: Try not to confuse similar illnesses. Two of the most common
causes of joint pain in children are rheumatic fever and juvenile arthritis. Even
some doctors and health workers get them mixed up and diagnose juvenile
arthritis as rheumatic fever. The two illnesses do have similarities. However,
rheumatic fever almost always follows a period of sore throat with fever. If the
child did not have a sore throat, probably the joint pain is not due to rheumatic
fever. When in doubt, however, 10 days of penicillin may be a wise precaution.
See p. 154 for information on doses of penicillin.
Carefully study the differences between the common causes of joint pain. If you are
not sure, seek help from someone with more experience.