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Should Your Child See a Doctor?

Arm Pain

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Definition

  • Pain in the arms (shoulder to fingers)
  • Includes shoulder, elbow, wrist and finger joints
  • The pain is not due to a known injury
  • Minor muscle strain and overuse injury are covered in this topic

Causes 

  • Arm pains are unusual
  • Main Causes: Strained muscles from overuse injury (e.g., excessive throwing or swimming)
  • Brief pains (1 to 15 minutes) are usually due to muscle spasms. These usually occur in the hand and follow prolonged writing or typing.
  • Continuous acute pains (hours to 7 days) are usually due to overstrenuous activities or forgotten muscle injuries during the preceding day. These are most common in the shoulder area.
  • Mild muscle aches also occur with many viral illnesses.
  • Serious Causes: fractures, arthritis (joint infection) and neuritis (nerve infection)

When to Call Your Doctor for Arm Pain

Call 911 If…

 
  • Your child is not moving or too weak to stand
 

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Can't use arm normally
  • Fever is present
  • Can't move a joint normally
  • Swollen joint
  • Bright red area on skin
  • Muscle weakness (loss of strength)
  • Numbness (loss of sensation) present over 1 hour
  • Severe pain or cries when arm touched or moved
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

 
  • You think your child needs to be seen

 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Cause of arm pain is uncertain
  • Arm pain present over 7 days
  • Arm pains or muscle cramps are a recurrent chronic problem
 

Parent Care at Home If

  • Caused by strained muscles from excessive use
  • Cause is obvious and harmless (e.g.,sliver that's removed, a recent shot)
 

Home Care Advice for Overuse Injury (STRAINED MUSCLES)

  1. Reassurance:
    • Strained muscles are very common following vigorous activity (overuse injury) (e.g., repeatedly throwing a ball). You can treat them at home.
     
  2. Local Cold: Apply a cold pack or ice bag wrapped in a wet cloth to the sore muscles for 20 minutes several times on the first 2 days.
  3. Pain: For pain relief, give acetaminophen every 4 hours OR ibuprofen every 6 hours as needed. (See Dosage table)
  4. Hot Bath: If stiffness persists over 48 hours, have your child relax in a hot bath for 20 minutes 2 times per day, and gently exercise the involved part under water.
  5. Expected Course: A strained muscle hurts for 2 or 3 days. The pain often peaks on day 2. Following severe overuse, the pain may last a week.
  6. Call Your Doctor If:
    • Fever or swollen joint occurs
    • Pain caused by work or exercise persists over 7 days
    • Pain becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. Brenner JS and the Council on Sports Medicine and Fitness. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics. 2007;119(6):1242-1246.
  2. Feiste JE, et al. After the flu: Acute viral myositis. Contemp Pediatr. 1995;12(3):29-52.
  3. Inocencio JD. Musculoskeletal pain in primary pediatric care: Analysis of 1000 consecutive general pediatric clinic visits. Pediatrics. 1998;102(6). URL: http://www.pediatrics.org/cgi/content/full/102/6/e63.
  4. Morse JW, Ridenour R, Unterseher P: Trichinosis. Infrequent diagnosis or frequent misdiagnosis? Ann Emerg Med. 1994;24:969-971.
  5. Waanders NA, Hellerstein E, Ballock RT. Nursemaid’s elbow: Pulling out the diagnosis. Contemp Pediatr. 2000;17(6):87-96.  

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/13/2010 6:26:40 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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