Our six-year old son has spastic cerebral palsy. The uneven muscle tone in his legs is causing a problem with the hips. To prevent hip dislocation, he had surgery on both hips. He came out of his hip spica cast about a week ago. He’s been complaining of leg pain ever since. Is this normal?

Pain after cast removal should be investigated by the surgeon. If your son has not been seen for this problem, a follow-up visit is advised. An X-ray to rule out bone fracture is the first step. The X-rays can also be reviewed to get an idea of the overall bone condition.

Loss of bone mineral density is common after surgery and prolonged cast immobilization. Bone loss can cause pain. A postoperative program of vitamin D and calcium supplementation may be prescribed. Some physicians also prescribe medications called bisphosphonates to prevent further bone loss.

Weight bearing activities can also be very helpful. If your son isn’t able to walk, a standing program may be beneficial. If the bone pain is caused by bone loss, a program of medications, supplementation, and weight bearing should reduce painful symptoms quickly.

If symptoms are not alleviated, then some other cause of the problem is possible. The physician will conduct further testing to identify and treat the problem.