Musculoskeletal Pain in Children

What are the signs and symptoms of musculoskeletal pain?

Musculoskeletal pain can cause a variety of sensations:

• It can feel like a sharp, stabbing pain or a dull ache.
• Sometimes musculoskeletal pain can cause a burning feeling.
• Injured muscles can twitch and spasm causing significant discomfort.
• In children unable to verbalize their pain, musculoskeletal pain can cause avoidance of using a body part (for example, a child who started walking and then won't walk anymore may be a sign of pain).
• Sometimes, musculoskeletal pain can feel like "all over" body pain.
• Other symptoms include fatigue and trouble sleeping.
• Signs such as swelling or bruising may result from a trauma like a fall or other impact.

If your child has suffered a known or suspected trauma recently and has physical signs of injury, see a doctor immediately to make sure there are no fractures or other internal injuries.

What tests are used to diagnose musculoskeletal pain?

At Children's Hospital Colorado, your child's doctor will perform a full history and physical exam to help determine the cause of the pain. At our Chronic Pain Clinic, this includes a complete assessment of the pain history and previous workup, a physical therapy evaluation and an assessment of all psychosocial factors that play a role in your child's pain.

Imaging tests are often used in the evaluation of musculoskeletal pain; these tests include X-rays, ultrasounds, CT scans and sometimes MRIs. CT scans and MRIs are longer exams and may require sedation. Sometimes laboratory tests looking for signs of inflammation may be ordered. While this would require a blood sample, our nurses and laboratory technicians are highly skilled at working with pediatric patients.

At Children's Colorado, we always keep your child's comfort in mind and our clinicians will order the fewest and least invasive tests possible in order to make the proper diagnosis. Specialists at the Chronic Pain Clinic will use these test results to help create an individualized plan for your child’s pain.

Why choose Children's Colorado for these tests?

We have a vast array of medical specialty teams available to help diagnose and treat your child's pain. We have almost every medical specialty and subspecialty available in our hospital, and we work with each other to provide the best care possible for your child.

Not only do all specialists have access to your child's electronic medical record, but we are also constantly talking with each other to help figure out the best treatment for your child. If your child needs sedation or anesthesia for their test or procedure, we have over 50 specialty-trained pediatric anesthesiologists and anesthetists who will make sure your child is safe and comfortable during the test or procedure.

What to expect from the tests?

These test range from very fast and non-invasive, to longer and more invasive studies that may require an IV or a blood draw. We make every effort to make sure your child is comfortable; we have child life specialists that can help provide comfort and distractions to children who are anxious or scared.

How do providers at Children's Colorado diagnose musculoskeletal pain?

The providers at Children's Colorado will integrate all the information from the history, physical exam and diagnostic tests to figure out the source of your child's pain. In more complex cases, providers may make referrals to other specialists to help with accurate diagnosis and to figure out the best treatment plan for your child. We all work together to find the answer to the problem and the best way to help fix it.

How is musculoskeletal pain treated?

Treatment of chronic musculoskeletal pain depends on the cause and location of the pain. At Children's Colorado, we use the latest evidence-based medicine in the treatment of pain; typically, treatment includes a combination of medications, pain psychology interventions (biofeedback, cognitive behavioral therapy, relaxation techniques), physical therapy or occupational therapy. Sometimes procedures or even surgery may be needed to treat certain conditions. These decisions will be made by your team of providers and will be discussed in detail with you during your visit.

Why choose Children's Colorado for your child's musculoskeletal pain?

As the only pediatric specialty pain clinic in the region, we have a comprehensive list of specialists to help with your child's diagnosis and treatment. Our experts work very closely together to provide the best possible care for your child in pain.

Specialists in our Chronic Pain Clinic offer a multi-disciplinary approach to your child’s pain. Children's Colorado has the only pediatric chronic pain clinic in the region, and we often treat children who have not made progress with other specialty clinics (for example, orthopedics, rheumatology, rehabilitation medicine and neurology).

• PALS (Parents and Adolescents Living Strongly) is a support group for teens with chronic illness and their parents offered through the Chronic Pain Clinic.