Growing pains and vitamin D supplementation

NewsBot · Mar 20, 2014

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Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study
Grazia Morandi et al
Journal of Bone and Mineral Metabolism, March 2014

The aim of our study was to analyze the possible relationship between growing pains, vitamin D levels, and bone mineral status. We enrolled 33 children affected by growing pains. Their pain intensity was evaluated through a questionnaire using the Wong–Baker Faces Pain Rating Scale for pain assessment. Serum 25-hydroxyvitamin D (25-OH-D), parathyroid hormone (PTH), and alkaline phosphatase levels were measured as well. A quantitative ultrasound assessment (QUS) was also done, measuring both the amplitude-dependent speed of sound (AD-SOS) and the bone transmission time (BTT), correlating, respectively, with bone density and with cortical thickness. After 3 and 24 months of vitamin D supplementation, we re-evaluated pain intensity and laboratory results. After 24 months we re-assessed QUS parameters. At the beginning of the study the children reported a mean growing pain intensity of 7.5 ± 1.6 SD. The mean values of 25-OH-D and PTH levels were 15.7 ± 6.9 ng/ml and 57.3 ± 27.3 pg/ml, respectively. The AD-SOS Z score was −0.53 ± 1.19 SD, and the mean value of the BTT Z score was −0.72 ± 0.96 SD. After the first 3 months of vitamin D supplementation we observed an increase in 25-OH-D levels (34.1 ± 17.8, p < 0.001) and a reduction in both PTH levels (47.3 ± 30.6, p = 0.135) and pain intensity (2.7 ± 2.2, p < 0.001). After 24 months we observed a further significant reduction in the pain intensity (3.9 ± 3.4, p < 0.001) and in PTH levels (43.7 ± 28.5, p = 0.004) and an improvement in the QUS parameters, in particular in BTT Z scores (p = 0.014). Our study suggests an interesting relationship between growing pains, vitamin D levels and bone mineral status.
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Admin2 · Mar 20, 2014

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NewsBot · May 30, 2015

Are Growing Pains Related to Vitamin D Deficiency Efficacy of Vitamin D Therapy for Resolution of Symptoms
Vehapoglu Aet al
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre) Online First

Objectives: The aim of this study was to investigate the 25-hydroxyvitamin D [25(OH)D] status of children with growing pains and to evaluate the efficacy of vitamin D treatment on the resolution of pain symptoms.
Subjects and Methods: One hundred and twenty children with growing pains were included in a prospective cohort study. Serum 25(OH)D and bone mineral levels were measured in all subjects at the time of enrollment. The pain intensity of those with vitamin D deficiency was measured using a pain visual analog scale (VAS). After a single oral dose of vitamin D, the pain intensity was remeasured by means of the VAS at 3 months. The 25(OH)D levels and VAS scores before and after oral vitamin D administration were compared by means of a paired Student's t test.
Results: In the 120 children with growing pains, vitamin D insufficiency was noted in 104 (86.6%). Following vitamin D supplementation, the mean 25(OH)D levels increased from 13.4 ± 7.2 to 44.5 ± 16.4 ng/ml, the mean pain VAS score decreased from 6.8 ± 1.9 to 2.9 ± 2.5 cm (a mean reduction of -3.8 ± 2.1, p < 0.001) and the difference was statistically significant.
Conclusion: Supplementation with oral vitamin D resulted in a significant reduction in pain intensity among these children with growing pains who had hypovitaminosis D.
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drhunt1 · May 30, 2015

NewsBot said: ↑

Are Growing Pains Related to Vitamin D Deficiency Efficacy of Vitamin D Therapy for Resolution of Symptoms
Vehapoglu Aet al
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre) Online First
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How did the researchers determine that the pain was non-articular? This is, IMO, a common misconception among medical practitioners and researchers. Further, they found that resolution of the pain with Vit. D supplementation was "statiscally improved"...how about completely removed and treated with a simple orthotic device, as I have found? Thanks for the link, though.

NewsBot · Aug 11, 2015

Prevalence of Vitamin D Deficiency in Korean Children Presenting with Nonspecific Lower-Extremity Pain
Min Jung Park, Juyeob Lee, Jun Ku Lee, and Sun Young Joo
Yonsei Med J. 2015 Sep;56(5):1384-1388

Purpose
Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains.

Materials and Methods
From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were excluded, as were those with underlying medical conditions, such as cerebral palsy and metabolic disease. Ultimately, 140 patients met the inclusion criteria. Levels of serum 25-hydroxy vitamin D [25-(OH)D], the ideal indicator of vitamin D status, were measured in these children.

Results
Eighty-seven boys (62.1%) and 53 girls (37.9%) were included. The mean age at presentation was 5.2 years (range, 2-15). Serum 25-(OH)D levels were <10 ng/mL in 5.7% of patients, 10 to <20 ng/mL in 51.4%, 20 to <30 ng/mL in 37.9%, and ≥30 ng/mL in only 5.0%. Most patients visited the hospital in the winter (41.4%) (summer, 12.9%), and serum 25-(OH)D levels were also lowest in the winter (17.2?5.5 ng/mL).

Conclusion
This study found a high prevalence of vitamin D deficiency or insufficiency in Korean children with nonspecific lower-extremity pains, indicating a positive association between vitamin D deficiency and growing pains. More attention should be directed toward vitamin D and its role in the optimization of bone health.
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NewsBot · Nov 4, 2017

Is vitamin D useful in the treatment of growing pains?

drhunt1 · Nov 5, 2017

Hardly helped by Vit. D...a placebo would probably have the same effect. Liquid ibuprofen at dinner and before bed works better, as it is an inflammatory condition. Transient synovitis of the STJ is actually what it is...not a Vit. D deficiency.

NewsBot · Dec 9, 2018

Association between the occurrence of growing pains and vitamin-D
deficiency in Indian children aged 3-12 years
Shruti Sharma et al
Sri Lanka Journal of Child Health, 2018; 47(4): 306-310

Introduction: Growing pains (GP) is a wellrecognized
entity in children aged 3-12 years. Its
diagnosis is based on Peterson criteria. The exact
aetiology of GP is not known; however, some
studies have linked GP and vitamin-D deficiency.
Objective: To find out the association between
occurrence of GP and vitamin-D deficiency (VDD)
in Indian children aged 3-12 years.
Method: Children presenting with GP, fulfilling
Peterson criteria, were enrolled in the study group,
along with an equal number of age and sex
matched healthy controls. Analysis of serum
calcium, phosphorus, alkaline phosphatase and
serum 25-hydroxy-vitamin-D [25(OH)D] levels
were done. The results of cases and controls were
compared; those children found to have VDD were
supplemented with Vitamin-D and response in pain
was noted after one month.
Results: Forty five children each were enrolled in
the GP and control group. Prevalence of VDD in
GP group was (41/45) 91.1% and in control group
(26/45) 57.8% [p-value 0.001, RR=7.490; 95%,
CI=2.290-24.496]. The mean value of serum
calcium, phosphorus, alkaline phosphatase in GP
group were 9.50 mg%, 5.15 mg%, 271 IU/L; while
in the control group they were 8.84 mg%, 4.72
mg%, 216.2 IU/L respectively. At one month
follow-up of GP group, (31/45) 68.9% became
asymptomatic while remaining 14 children showed
improvement in symptoms.
Conclusions: Children, 3-12 years old, presenting
with GP are more likely to have VDD compared to
children without GP
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NewsBot · Jan 19, 2020

Growing Pain Among Bangladeshi Children: Urban and Rural Settings
Shafi Ahmed
ACTA SCIENTIFIC PAEDIATRICS Volume 3 Issue 2 February 2020

Vitamin D plays role in regulating cell growth, maintenance of body immunity, healthy musculoskeletal structure and functioning
other various biological activities in keeping people healthy. This study was a part of a community based cross sectional study which
was conducted among 274 primary school children. Two primary schools were selected purposively (one from Dhaka city and one
from Gazipur district). The male and female ratio was equal. The mean age of the students was 8.86 ± 2.035 years. Majority of the
children were within 5 – 10 years (73.7%) and rest were within 10 – 14 years. The male and female ratio was equal. Among the participants 28.8% were in class I, 20.1% were in class II, and 16.4% were in class III, 17.9% in class IV and rest 16.8% were in class V.
Among the study participants 48.2% were of rural areas and 51.8% were from urban area. Among the participants, 97.0% of the rural
areas and 75.4% of the urban areas had growing pain. By pain status of the rural participants, 89.8% reported their pain as mild and
10.2% as moderate while 38.3% of urban participants reported their pain as mild, 60.7% as moderate and 0.9% as severe. Statically
significance association was found between residence of the participants with development of growing pain and increasing manner
of pain status (p<0.05). Among the rural children 60.9% had no scope of regular sun exposure, while among the urban children it is
27.1% (p<0.05). Growing pain was reported in increasing manner among those who had scope of sun exposure for 2 hours per day,
for 2 – 5 hours and who had no scope of regular sun exposure (p<0.05). Prevalence of growing pain and insufficient sun exposure
especially among rural school going children in Bangladesh is very high and alarming which needs to explore the root cause
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NewsBot · Jun 7, 2021

Limb Pain and Vitamin-D Insufficiency in Children
AKM Mamunur Rashid
J Pediatr Neonatol. 2021;2(2):1014.

A number of children frequently visit in our daily practice with presenting symptom of limb pain especially at night. There might be a relationship between low
level vitamin-D and limb pain in children. The children presenting with nonspecific limb pain without signs of joint inflammation and other diseases visited to
the private clinic are included in this study. These children are sent to the laboratory for the assessment of vitamin-D level in their blood. Their vitamin –D level is
analysed to find out the relation with the limb pain. 30 children are included in this study. Among which 63% male and 37% is female children. Majority is found
between the ages of 6-10 years. Low Vitamin-D level than normal is observed in 86.6% of the children. Vitamin-D insufficiency is found in 57% and deficiency
in 30% of children. Only 13% has normal vitamin-D level. Low vitamin-D level in children might be an important cause of nonspecific limb pain. Vitamin-D
supplementation and sun exposure of the children is necessary for the prevention of this nonspecific complain and illness.
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NewsBot · Jun 23, 2022

Vitamin D Deficiency in Children/Adolescent Presenting with Night Time Legs Pain
Naheem Ahmed, Kiran Ashfaq Ahmed, Tayyaba Siddique, Raja Imtiaz Ahmed, Muhammad Aftab, Rashada Bibi
Vol. 16 No. 04 (2022): Pakistan Journal of Medical & Health Sciences

Objective: To determine the frequency of vitamin D deficiency in children/adolescent presenting with night time leg's pain at Sheikh Khalifa Bin Zayed Al Nahyan Hospital Ak CMH Muzaffarabad.

Methodology: This was a cross-sectional study, which was conducted at the pediatric Department SKBZ/CMH Muzaffarabad, during six months from July 2021 to December 2021. All the adolescent children presented with leg's pain during sleep at night and both genders presenting at paediatric OPD were included. After obtaining informed consent, a 3ml blood ample was obtained from each case and immediately sent to the Hospital diagnostic laboratory to assess the vitamin D level. All demographic information, including vitamin levels, were documented via study proforma and SPSS version 26 was used to enter and analyze all of the data.

Results: A total of 60 adolescent children who presented with leg's pain were studied to observe their vitamin D levels and their average age was 05.93+2.94 years. Out of all, 40 (66.7%) cases were males and 20 (33.3%) were females.

Only two children were found with normal vitamin D level, and from all of the remaining 50.0% had vitamin D deficiency (<20 ng/mL) and 46.7% had insufficiency (20–30 ng/mL). Vitamin D deficiency was statistically significant according to age (p-0.006), whereas it was statistically insignificant according to gender (p-0.117).

Conclusion: Vitamin D deficiency was observed to be higher among almost all the cases presented with leg's pain during the night. This was an alarming situation to our current generation. According to these findings, it is estimated that vitamin D deficiency increases with increasing age.
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NewsBot · Nov 17, 2022

Serum Vitamin D and Bone Mineral Density in Children with Growing Pain in a Tertiary Hospital of Bangladesh
Md. Asif Ali, Mujammel Haque, Mohammad Imnul Islam, Mohammad Zahirul Islam Khan, Shahana Akhter Rahman
Open Journal of Pediatrics > Vol.12 No.5, November 2022

Background:Growing pain (GP) is the most common form of nonspecific, recurrent leg pain in children aged 4 - 12 years. The exact etiology of GP is not known. However, some studies have found an association between vitamin D and Bone Mineral Status (BMD) status with GP in their study. Objectives: To assess the serum level of vitamin D, and BMD and to determine their association with growing pain in children. Methods: This cross-sectional analytical study was conducted in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). Sixty children between the age of 6 - 12 years were included in the study from March 2020 to August 2021. Children who fulfilled the Evans criteria of GP were enrolled as cases and thirty age and sex matched healthy children were recruited as the control in the study. Informed written consent was obtained from patients and parents. Serum 25-hydroxy-vitamin-D levels and BMD were performed among cases and controls and subsequently compared to see their association in growing pain. A preformed semi-structured questionnaire was completed for each participant which included socio-demographic, clinical and laboratory characteristics. Appropriate statistical tests were applied for data analysis and performed by SPSS version 22. A p-value less than 0.05 was considered as significant at a 95% confidence interval. Results: In this study, 96.7% of growing pain patients had hypovitaminosis D and among them, the majority (86.7%) was vitamin D deficient. There was a significant association between vitamin D with GP compared to healthy control. BMD was significantly lower in the lumbar vertebra (L1 - L4) and femoral neck region (both right and left) among GP children compared to the control group. Conclusion: From this study, it may be concluded that the majority of children with GP had hypovitaminosis D and low BMD status compared to the control. Vitamin D deficiency and low BMD status were significantly associated with children with growing pain. Institutional Review Board (I.R.B.) Clearance Certificate (NO. BSMMU/2020/4503 Date: 15/03/2020) was provided from the office of the Registrar, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
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NewsBot · Mar 20, 2023

Frequency of Hypovitaminosis D in Children with “Growing Pains”
Shah Nawaz et al
Source

Objective: To determine the frequency of Hypovitaminosis D in kids by increasing pains and
to find out the relationships among biochemical biomarkers and serum vitamin D concentration levels.
Study Design: An exploratory cross-sectional investigation was conducted. Methodology: Growing
pains were diagnosed in 100 outpatient children aged 5–12 with diffuse lower leg pains. The study
excluded infants with arthritis, systemic diseases, organic pain, rheumatologic diseases, or rickets
symptoms. We measured total inorganic phosphate, calcium, alkaline phosphatase, and vitamin D3 (25-
hydroxycholecalciferol). Group A had enough vitamin D3 (> 75 nmol/L), Group B had 50–75, and
Group C had levels below 50. Group rates mattered at 0.05 in the chi-square test. Results: 9-year-olds
and 60% women participated. 7% of infants with growth pains had enough vitamin D. 95% of vitamin
D-deficient babies had high alkaline phosphatase. Conclusion: Growth pains may cause hypovitaminosis
D. Youngster's Vitamin D levels should be tested for unusual leg pain. Molecular clues cannot diagnose
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