Growing Pains in Children

Ian North · Dec 7, 2004

Members do not see these Ads. Sign Up.
Recent Article in the Journal of Pediatric Orthopaedics.

Growing Pains: Are They Due to Increased Growth During Recumbency as Documented in a Lamb Model?
Noonan, Kenneth J. MD; Farnum, Cornelia E. DVM, PhD; Leiferman, Ellen M. DVM; Lampl, Michelle MD, PhD; Markel, Mark D. DVM, PhD; Wilsman, Norman J. DVM, PhD
Journal of Pediatric Orthopedics. 24(6):726-731, November/December 2004.

The rate and patterns of longitudinal bone growth are affected by many different local and systemic factors; however, uncompromised growth is usually considered to be smoothly continuous, with predictable accelerations and decelerations over periods of months to years. The authors used implanted microtransducers to document bone growth in immature lambs. Bone length measurements were sampled every 167 seconds for 21 to 25 days. The authors show that at least 90% of bone elongation occurs during recumbency and almost no growth occurs during standing or locomotion. The authors hypothesize that growth may also occur in children during rest or sleep, thus supporting the concept of nocturnal growth and perhaps a relationship to growing pains.
Click to expand...

The authors suggest the growth plates are compressed during weightbearing.
" A possible mechanism of pain may result from increased tension in the periosteum as the growth plates sping back from released compression or by some signal transduction mechanism during recumbency."

With the successful use or orthoses and triplanar wedges in the reduction of symptoms associated with "growing pains", or lower leg aches are we seeing a mechanical affect on the bones/growth plates or simply reducing muscle fatigue ???

Thoughts ???

Sean Millar · Dec 7, 2004

Could it be that wedges and other biomechanical foot devices reduce periosteal tension/tugging, therefore reducing overall stress/inflammation experienced during periosteal growth phases.

davidh · Dec 7, 2004

Ian North said:

With the successful use or orthoses and triplanar wedges in the reduction of symptoms associated with "growing pains", or lower leg aches are we seeing a mechanical affect on the bones/growth plates or simply reducing muscle fatigue ???

Thoughts ???
Click to expand...

Bit of both, I would have thought .
A search on "growing pains" will reveal several theories, only one of which is described in this article.
Regards,
David

admin · Dec 8, 2004

Relationship Between "Growing Pains" and Foot Posture in Children Single-Case Experimental Designs in Clinical Practice
Angela M. Evans

Many young children present to the podiatric physician with the complaint of aching legs. Many of these children are clinically assessed as having a pronated foot posture. This foot posture is thought to be deleterious and is often treated with in-shoe devices such as triplane wedges or orthoses. Intervention aiming to reduce the amount of foot pronation in both stance and gait has been reported by parents and children to reduce, and in many cases eliminate, the episodes of aching legs. To test this theory and establish a degree of causality, a single-case experimental design was used in conjunction with age-appropriate pain scores for the children and independent parental ratings. Single-case experimental design is a useful research tool for the clinical practice setting that can identify cause-effect relationships and obviates large sample sizes. Eight complete single-case experimental designs were performed in the clinical setting. The in-shoe intervention proved efficacious for children with a pronated foot posture and aching legs. These findings may provide the impetus for a more rigorous examination of the possible relationship between pronation and "growing pains." (J Am Podiatr Med Assoc 93(2): 111-117, 2003)
Click to expand...

Growing pains affecting one in three young children
By Geraldine Hinter

Growing pains are a bigger problem for young children than first thought, affecting one child in every three, a UniSA study shows.

Parents of children aged between four and six from across South Australia took part in the study by completing questionnaires on the prevalence of growing pains in their children.

This is the first time that research has focused specifically on young children to determine the extent of the problem. It is these young children who are purported to be the most affected but have been the least studied, according to podiatry PhD student Angela Evans from UniSA’s School of Health Sciences.

“Growing pains affect a lot of young children (36.9 per cent of children in our study) to the point that they’re seeing a health professional or taking pain medication. It has also been estimated in other studies that children with growing pains who frequently see medical or other health practitioners can take up between five and seven per cent of health care resources, which is considerable,“ Evans says.

“Children who are otherwise healthy and well can be described as having growing pains when they experience recurrent leg pain and aches in both legs. It is important to note that these pains occur in the muscle groups, not in the joints, which differentiates them from more serious conditions.

“Growing pains typically start late in the day, particularly at night, and are more likely to occur after increased activity. The level of distress varies from complaints by some children to crying and screaming by others, depending on the intensity of the pain. In terms of frequency, it seems to go in spates, from say, four times in a week to nothing for a month, making it difficult to monitor,“ Evans says.

“While there’s a lot that we still don’t know about growing pains, it has been classically diagnosed by the exclusion of more serious conditions.

“It is important for health care professionals to be more aware of this too often dismissed childhood problem where, in about 70 per cent of cases, there is a family history of growing pains.“

Evans is conducting world-first research to compare children with and without growing pains to see if there is a difference anatomically in their foot posture.

“Preliminary testing suggests that there is an association between children’s foot posture and leg pains and we are investigating to see whether that theory is a factor,“ she says.

“We have developed the best methods for accurately measuring the anatomical part of the foot for children aged four, five and six by using ultrasound to make sure that measurements are valid.“

Research that leads to identifying the cause of growing pain will help children and their parents to better manage the condition and reduce the number of visits to health professionals, according to Evans, whose research is being supervised by Associate Professor Sheila Scutter, Dean of Teaching and Learning in the Division of Health Sciences. UNISANews
Click to expand...

Ian North · Dec 8, 2004

Theres no doubt that orthoses help symptoms of children with lower leg aches as demonstrated by A.Evans. We see this on a daily basis. The greatest effect of such devices is most likely on soft tissues and muscle function as opposed to recumbent leg growth as documented in the original article. It raises the old question "do growing bones hurt" ???

admin · Aug 31, 2005

From the Australasian Podiatry Council Conference in Christchurch, NZ:

Angela Evans
Are Foot Posture and Functional Health Differrent in Children with Growing Pains?

180 children; surveyed for growing pains and several health status measures.
Several foot posture measures used (parts of FPI; navicular height and drop; etc).

No clinical differences found in foot posture between those with growing pains and without.

Kevin Kirby · Aug 31, 2005

Growing Pains in Children and Sports Injuries in Adults Share Common Etiologies

Over the past decade, I have often stated that the podiatry and medical communities should be able to clearly see that children's "growing pains" are nothing more than a form of sports or athletic injury that we see commonly in adults. Children run and play most of the day. The normal running, jumping and playing activities that children perform on a daily basis, when combined with suboptimal structure and function of the foot and lower extremity, will lead to increased abnormal tissue stresses which will cause pain and injury.

These athletic injuries, for some reason, have been called "growing pains" in children. However, if an adult goes out and runs, jumps and plays the same number of hours per day that a child does, develops similar aches and pains, we say they are "overdoing it" and have developed a "sports injury".

From my perspective of seeing many children with "growing pains" and adults with "sports injuries" of the lower extremities for over 20 years, these two sets of injuries occur due to the same reasons. Therefore, children's growing pains should be treated just like sports injuries in adults: modified rest, ice, stretching, shoegear changes, over-the-counter orthoses and possibly custom foot orthoses.

Kevin Kirby · Aug 31, 2005

I just went back over the Precision Intricast Newsletters I have done over the past few years and found that my August 2003 Newsletter was titled "Growing Pains in Children" where I discussed the research by many authors including Angela Evans' wonderful JAPMA paper from 2003.

Here a few excerpts from the newsletter:

Later, in 1992, Kirby and Green noted in children with flexible flatfoot deformity that also had lower extremity symptoms due to “growing pains”, the vast majority had their symptoms resolve with the use of foot orthoses. Due to the excellent therapeutic results that foot orthoses showed in clinically resolving growing pains, we concluded that “mechanical instability of the foot during weightbearing activities may, therefore, be a substantial cause of growing pains in some children” (Kirby KA, Green DR: Evaluation and Nonoperative Management of Pes Valgus, pp. 295-327, in DeValentine, S.(ed), Foot and Ankle Disorders in Children. Churchill-Livingstone, New York, 1992).
Click to expand...

And the last paragraph of the newsletter:

Children run and play a good portion of their days, much more than adults realize. It seems logical to assume that since adults commonly seek medical attention for their over-use injuries from running and playing too much for their individual biomechanical make-ups, children also experience pain in their extremities that is likely related to their running and playing too much for their individual biomechanical make-ups. Therefore, the common and painful condition of “growing pains”, which has probably been erroneously attributed to the growth process for the past 180 years, is now getting new attention in the medical literature that will hopefully result in many more children being treated successfully and not continuing to suffer needlessly with lower extremity pain.
Click to expand...

One Foot In The Grave · Sep 27, 2005

I'm in the process of putting my 4yo into some orthotics in the hope of reducing the number of times he complains of sore feet and legs (and to reduce the crying and sleeplessness that goes with it!)

Just through observation (& not particularly vigilant obs at that!) I can equate the nights he waks up with sore legs to the days when he's been busiest. I've always assuemd it was "overuse" rather than growing pains.

Kate Grundy · Jan 19, 2006

Dear all experts
Having treated children with "growing pains" for approx 20 years of my career I can say that in a large majority of children that complain consistently about "aching legs", reluctance to walk distances and asking to be carried because "my legs are tired", a functional biomechanical abnormality can be found. Most commonly an overpronated gait pattern. If this is successfully addressed then I become a miracle worker as far as the parent is concerned. The child stops complaining and waking at night and not wanting to walk. This is I accept not backed up by a research project done by me but on my clinical expereince. I think it would be an interesting Masters study if I can ever pluck up the energy to do one. In the meantime I will continue to treat these children in the same way as it gets the results the parent (and I hope the child) wants.
I accept as Mr Kirby states that some of these pains may be as a result of overuse as a child who runs around a lot may be very alike the pains an athelete gets when training but a lot of the chilren that I see arn't running around because of the pans that they get and because the legs are tired as a result of the compenatory nature of the gait patterns they are exhibiting. Once this is controlled then they can run around more withou the pain. I am doing a presentation on this very subject to colleagues so would value any information/ researchthat I could use to support this. I think the pain levels vary from child to child just as pain levels vary from adult to adult depending on their individual pain thesholds so it is difficult to quantify whether the "crying with pain" child is actually in more pain than the child who is just complaining. it is good to know that research is going on in these areas.
Kate Grundy
Podiatrist NHS UK

NewsBot · Jul 29, 2006

“Growing pains” in young children: A study of the profile, experiences and quality of life issues of four to six year old children with recurrent leg pain
The Foot Volume 16, Issue 3 , September 2006, Pages 120-124

Background
Growing pains is a common yet misunderstood condition which presents frequently to health professionals and appears to be significantly under reported. Little is known about the profile of affected versus unaffected children.

Method
This research used a validated questionnaire (USAGPQ) for parents of children aged four to six years to explore characteristics such as basic anthropometry, family history, physical activity levels, quality of life (QoL) and the pain experience of affected children. The health professional consulted and resulting treatment or investigations were also surveyed in a systematic random sample of 743 children in South Australia.

Results
Based on parental responses: only 35.9% children were seen by health professionals; pain medication was the most common intervention prescribed (17.1%); a family history of growing pains was reported in 69.8% cases. In no reported cases was a muscle stretching program used, despite this measure having best evidence for management. Children experiencing growing pains had significantly greater body weight (approximately 5% greater), same activity levels and in a minority of cases (5.7%) reduced QoL estimates.

Conclusions
This study shows that the management of growing pains is not evidence based and occurs in isolation from health care professionals. The finding of growing pains being associated with increased weight requires further exploration given the concerns of childhood obesity. This prevalent condition affects some young children with considerable frequency and may impact quality of life of these children. This condition is under reported, mismanaged and too often disregarded by health care professionals.
Click to expand...

NewsBot · Sep 1, 2006

Todays British Medical Journal has this editorial:
Growing Pains (only those with institutional access can get the full article

Freeman · Sep 27, 2006

For those nay-sayers who doubts mechanical stress is a factor, ask how many kids have growing pains in their arms, hands, etc. If they grow at the same rate as feet and legs, why do not children have growing pains there? I have had similar very good results with children over many years who I have treated as being biomechanically greater at risk or developing overuse stress injuries.

Last note: orthodonic dentristry seems to approach alignment with an early intervention attitude to prevent teeth, jaws from taking on an injurious attitude.
Best regards
Freeman Churchill, Certified Pedorthist (Canada)

yvonnespod · Oct 2, 2006

As a mother and pod ,whatever order you please, my 6years old has experience "Growing pains" -unilaterally in his left calf -occasionally for approx 3 years and only after a busy day and going to bed later than usual Panadol helped
Can growing pains be unilateral? yvonnespod

carol · Oct 8, 2006

unnilateral growing pains

As another mother and Pod, please get your 6 year old with unilateral pains checked for Juvenile Arthritis, my Daughter suffered for 3 years before she was correctly diagnosed, she only has it in one knee but we were told for ages she had growing pains/ cartilage problems/ attention seeking etc etc
Don't panic though, they do grow out of it, my daughter is now 15 and hasn't had a flare for 6 months. And yes, orthotics help a lot, damage limita tion is imperative to prevent problems later on.

Podiatry777 · Feb 9, 2007

Re: Unilateral Growing Pains

Dear Mum/Pods,

Have you done a biomechanical assessment rulling out scoliosis,hip drop, leg length discrepancy? Orthotics work well wiith these patients if the biomechanical difference in R and L is not excessive. Have son 9 who developed aches early, and loves to run. Wears soft full length orthotics.

Pod777

Hylton Menz · Apr 24, 2007

Re: Growing Pains

Tuesday, April 24, 2007. 6:45am (AEST)

Sydney researchers begin study into 'growing pains'

Researchers at a Sydney hospital are investigating the cause of growing pains in children, but it appears the cause is unlikely to have anything to do with growing.

Nocturnal limb pain syndrome, or growing pains, is a common childhood complaint.

The syndrome affects many children aged between three and 13, with pain usually felt in the legs during the night.

Associate Professor David Champion of the Sydney Children's Hospital says there have been many theories about the causes, including growth, flat fleet and bone fatigue, but none have been proven.

He says it is likely to be caused by something similar to that of severe headaches.

"Migraine is clearly a disordered function of the nervous system and so it appears likely that growing pains syndrome is disordered function in nervous system," he said.

He says the hospital is looking for child volunteers to be part of the research that involves non-invasive tests and the findings will be released later this year.

He says he hopes the study will shed some light on the problem (more from the ABC...)

LuckyLisfranc · Apr 24, 2007

Re: Growing Pains

Hylton Menz said:

He says it is likely to be caused by something similar to that of severe headaches.

"Migraine is clearly a disordered function of the nervous system and so it appears likely that growing pains syndrome is disordered function in nervous system," he said.
Click to expand...

Migraine's??

Huh?!?

The dear professor seems to have grabbed two utterley different pathologies and brought them together from out of nowhere.

Is my education at fault - or does this seem like a complete load of nonsense - whatever current 'growing pains' theory you subscribe to!

Someone please enlighten me.

LL

NewsBot · Nov 23, 2007

Re: Growing Pains

Are foot posture and functional health different in children with growing pains?
ANGELA MARGARET EVANS, SHEILA DOREEN SCUTTER
Pediatrics International (OnlineEarly Articles).
doi:10.1111/j.1442-200X.2007.02493.x

Background: The aim of the present paper was to investigate and compare findings of foot posture and functional health between groups of children aged 4–6 years with and without leg pain (described as "growing pains"). The null hypothesis: that there is no difference in measures of either foot posture or functional health between groups of children with and without leg pain.

Methods: A stratified random sample of children was obtained. The children were identified with and without leg pain using a validated questionnaire for parents. The examiner was blind to the children’s pain status. The schools and child care centers were from each geographical quadrant of metropolitan Adelaide and a northern rural region of South Australia. One hundred and eighty children (94 boys, 86 girls) entered and completed the study. Children whose parents returned a completed questionnaire and consent form were entered into the study. All participants were assessed by the one examiner. The foot posture measures used were those found to be most reliable in previous studies and for which the intra-rater reliability of the examiner was ascertained.

Results: Initial analysis of foot posture measures between the leg pain and no leg pains groups indicated a statistically significant result for the measure of navicular height, but only on the left side (P = 0.033). Logistic regression modeling showed that navicular height (left foot only) was positively yet weakly related to growing pains (odds ratio, 1.072; 95% confidence interval: 0.991–1.160) and the effect was not significant (P = 0.08). Measures of functional health returned many statistically significant yet weakly correlated relationships.

Conclusions: The null hypothesis of the present study was supported in terms of clinical significance. While the foot posture measure of navicular height on the left foot was statistically significant it was not predictive for growing pains nor clinically significant as a measure between groups. The present study does not support the anatomical theory for growing pains and does not find a meaningful relationship between foot posture or functional health measures and leg pain in young children.
Click to expand...

JFAR · Jul 29, 2008

Re: Growing Pains

Growing pains: contemporary knowledge and recommended practice

Angela M Evans

Journal of Foot and Ankle Research 2008, 1:4doi:10.1186/1757-1146-1-4

Published: 28 July 2008

Abstract (provisional)

Background
Leg pain in children, described as growing pains, is a frequent clinical presentation seen by an array of health care professionals. Described since 1823, growing pains continues to puzzle practitioners, yet diagnostic criteria and evidence based treatment is available.

Methods
The medical literature has been searched exhaustively to access all articles (English language) pertaining to leg pains in children which are ascribed to being 'growing pains'.

Results
The literature, whilst plentiful in quantity and spanning two centuries, is generally replete with reiterated opinion and anecdote and lacking in scientific rigour. The author searched 45 articles for relevance, determined according to title, abstract and full text, resulting in a yield of 22 original studies and 23 review articles. From the original studies, one small (non-blinded) randomised controlled trial that focused on GP treatment with leg muscle stretching was found. Nine prevalence studies were found revealing disparate estimates. Ten cohort (some case-controlled) studies, which investigated pain attribute differences in affected versus unaffected groups, were found. One series of single case experiment designs and one animal model study were found.

Conclusions
Growing pains is prevalent in young children, presents frequently in the health care setting where it is poorly managed and is continuing to be researched. A common childhood complaint, growing pains needs to be acknowledged and better managed in the contemporary medical setting.

NewsBot · May 1, 2011

Press Release:
Study is the first to link sleep duration to infant growth spurts

A study in the May 1 issue of the journal SLEEP is the first to show that increased bursts of sleep among infants are significantly associated with growth spurts in body length.

Results show that infants had irregular bursts of sleep, with 24-hour sleep duration increasing at irregular intervals by an average of 4.5 hours per day for two days. The number of sleep episodes per day also increased in intermittent bursts of an average of three extra naps per day for two days. These peaks in total daily sleep duration and number of sleep episodes were significantly associated with measurable growth spurts in body length, which tended to occur within 48 hours of the recorded bursts of sleep. Further analysis found that the probability of a growth spurt increased by a median of 43 percent for each additional sleep episode and 20 percent for each additional hour of sleep.

“The results demonstrate empirically that growth spurts not only occur during sleep but are significantly influenced by sleep,” said principal investigator and lead author Dr. Michelle Lampl, Samuel Candler Dobbs Professor in the department of anthropology at Emory University in Atlanta, Ga. “Longer sleep corresponds with greater growth in body length.”

Lampl added that the results may be particularly helpful for parents, who can become easily frustrated by the variability and unpredictability of an infant’s sleep patterns.

“On a practical, everyday level, it helps parents understand their infant’s behavior and patterns,” she said.

The study involved 23 parents who consistently recorded daily sleep records for their infant, providing 5,798 daily records for analysis. The median age of the 14 girls and nine boys at study onset was 12 days. All infants were healthy at birth and free of colic or medical complications during their first year. For a duration ranging from four to 17 continuous months, growth in total body length was assessed using the maximum stretch technique, which was performed semi-weekly for 18 infants, daily for three infants and weekly for two infants.

According to Lampl and co-author Michael Johnson, PhD, professor of pharmacology in the University of Virginia Health System, the exact nature of the relationship between sleep biology and bone growth is unclear. However, they noted that the secretion of growth hormone is known to increase after sleep onset and during the stage of slow wave sleep. This change in hormonal signals during sleep could stimulate bone growth, which would support anecdotal reports of “growing pains,” the aching limbs that can wake children at night.

Although a statistically significant relationship between bursts of sleep and growth spurts was found in all infants, the correspondence was imperfect. Some sleep alterations occurred without a growth spurt, and not every growth spurt was preceded by a burst of sleep.

Lampl and Johnson speculate that in some cases growth may have occurred in other parts of the body. For example, another new study they are publishing this month found that infant head circumference grows in intermittent, episodic spurts. They also suggest that sleep may be only one component of an integrated, physiological system that underlies growth timing.

The study is also significant, added Lampl, because it adds a novel finding to the interdisciplinary, multi-faceted body of research targeted at answering the question, “Why do we sleep?”

“It opens another door to understanding why we sleep,” she said. “We now know that sleep is a contributing factor to growth spurts at the biological level.”
Click to expand...

NewsBot · May 31, 2011

A SCHOOLGIRL who was told she was suffering from growing pains turned out to have a life-threatening form of cancer.

Sophie Huntingdon was taken to a doctor suffering from aches in her knees last October.

But the 14-year-old was told the discomfort was merely down to her development.
Click to expand...

NewsBot · Jun 14, 2011

Growing Pains: A Study of 30 Cases and a Review of the Literature
Pavone, Vito, Lionetti, Elena, Gargano, Valerio, Evola, Francesco R., Costarella, Luciano, Sessa, Giuseppe
Journal of Pediatric Orthopaedics: July/August 2011 - Volume 31 - Issue 5 - p 606–609

Background: Data from the literature regarding the clinical profile of growing pains are limited. The purpose of this study was to define the clinical features, familial history, laboratory findings, and therapeutic outcome of growing pains in children.

Methods: Thirty children (18 male and 12 female; 3 to 14 y of age) who presented with growing pains between January 2006 and December 2007 were enrolled and prospectively followed up for 1 year. The inclusion criterion was lower extremity pain, which was recurrent and lasted for >3 months. The exclusion criteria were any abnormal systemic or local symptoms and signs, joint involvement, and limp or limitation of activity. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, and serum calcium and phosphorus levels, were performed in all children.

Results: The study group had pain during the night and afternoon in 43.3% and 56.7% of cases, respectively. Both lower limbs were involved in 80% of cases, causing awakening and crying episodes in 40% and 37% of cases, respectively. The frequency of pain was as follows: daily, 5%; weekly, 45%; monthly, 35%; and every 3 months, 15%. The pains were relieved by massaging the affected site in 95% of cases and by analgesics in 5% of children. A family history of growing pains was positive in 20% of patients. All patients had laboratory tests within normal values.

Conclusion: Growing pain is a frequent noninflammatory syndrome consisting of intermittent, often annoying, pains that affect the lower extremities of children. Clinical diagnosis is easy if precise inclusion and exclusion criteria in the history and physical examinations are strictly followed. Patients and family reassurance is mandatory.
Click to expand...

Robertisaacs · Jun 14, 2011

“mechanical instability of the foot during weightbearing activities may, therefore, be a substantial cause of growing pains in some children”
Click to expand...

What Kevin said.

Funny thing about growing pains is that they are (in my experience) probably the easiest fix with orthoses. If they are "growing pains" why should that be?

And why are they never in elbows?

Kevin Kirby · Jun 14, 2011

Robertisaacs said: ↑

What Kevin said.

Funny thing about growing pains is that they are (in my experience) probably the easiest fix with orthoses. If they are "growing pains" why should that be?

And why are they never in elbows?
Click to expand...

Robert:

I agree. I can't remember the last case of "growing pains" I didn't cure with custom foot orthoses. Funny, the children continued growing even with the orthoses.

NewsBot · Feb 23, 2012

Bone strength in children with growing pains: long-term follow-up
Y. Uziel, G. Chapnick, A. Oren-Ziv, L. Jaber, D. Nemet, P. Hashkes
Pediatric Rheumatology (in press)

OBJECTIVES:
To examine the changes in bone strength in a cohort of children with `growing pains` (GP) after 5 years follow-up and the correlation with pain outcome.

METHODS:
Bone strength was measured by quantitative ultrasound. Subjects were 39 children with GP previously studied. Controls were normograms based on the measurement of bone speed of sound in 1085 healthy children. Current GP status was assessed by parental questionnaires. Bone strength was compared with pain outcome.

RESULTS:
We examined 30/39 (77%) patients after 5 years. Bone strength was significantly increased when compared to the first study (Z score 0.65±1.77 vs. -0.62±0.90, p<0.001). While overall there was no significant difference in the bone strength between the 16 (53%) patients whose GP resolved and the 14 (47%) who continued to have GP episodes (p=0.71), all 6 (20%) patients with a speed of sound Z-score <-1 continued to have GP (p=0.003).

CONCLUSIONS:
Our findings that pain improves in most patients parallel to the increase in bone strength may support the hypothesis of GP representing in some patients a local overuse syndrome
Click to expand...

C Johnston · Feb 24, 2012

Couple of question folks put in the simplest of terms. Is it the growth of bone that causes the pain or the struggle of ligaments, tendons and muscles to 'catch up'. If the latter is the case, surely a stretching regieme may be more beneficial that othoses. If, in most cases, there is overpronation, could that not just be caused by 'tight' tendons. Just a thought.

NewsBot · Sep 22, 2016

Craig Payne · Sep 28, 2012

One of our students posted this in our internal learning forum. I have their permission to repost it here.

“My sister was diagnosed with growing pains at the age of 6 years. At first she experienced night pain, was at the typical age and the pain was poorly isolated.

It was not until the pain become localised, occurred both night and day, began to restrict her activity was this diagnoses questioned. Slowly over many months a hard mass on her tibia began to form. Tests revealed that she had a very large osteoblastoma on her tibia.“
Click to expand...

A timely reminder on the seriousness that "growing pains" needs to be given.

CraigT · Sep 28, 2012

she experienced night pain
Click to expand...

I believe the rule is that as soon as a paeds patient reports this, they need an Xray...
Was the poorly isolated pain unilateral or bilateral??

NewsBot · Oct 16, 2012

The Daily Telegraph are reporting:
'Our little girl's "growing pains" were actually cancer': Parents' anguish as daughter, 9, nearly loses leg to deadly bone tumour

A couple have revealed how their nine year old girl nearly lost her leg to bone cancer after doctors initially thought she had simply pulled a muscle.

Hannah Baker was left in agony as a 22cm tumour grew on her left leg, but was told it was probably a sports injury after visiting her GP. Her concerned parents, Paul, 36, and Shim, 36, assumed she was suffering from common growing pains.

However, two weeks later when the pain got worse, they rushed her back to her doctor who recommended an x-ray of the youngster's leg, which revealed the huge tumour on her femur.
Click to expand...

Full story

NewsBot · Oct 17, 2012

Here is another:
Highwood family’s ordeal met with community support

Sammy, 6, the second of the Sommers’ five children, complained of pain in his legs on Memorial Day. The Sommers thought it was growing pains, but took Sammy to see a doctor anyway. By June 9, Sammy had been diagnosed with acute myelogenous leukemia.
Click to expand...

NewsBot · Apr 15, 2013

Here is another:
Courageous schoolgirl Abby, 9, is winning her battle against rare cancer

A BRAVE schoolgirl diagnosed with a rare type of cancer after being told it was just growing pains is winning her fight against it.
Click to expand...

NewsBot · May 2, 2013

Is it restless leg syndrome or growing pains. From the Huff Post

NewsBot · May 16, 2013

Agony of schoolgirl's 'growing pains' turns out to be rare form of arthritis

When her five-year-old daughter began complaining that her legs hurt, her GP put it down to growing pains.

But when the pain became so terrible that weeks later her mother had to carry her around the house, it became clear that something was terribly wrong.

Doctors discovered that Alyssia Clayton-Minta had juvenile idiopathic arthritis (JIA) - a rare and serious form of arthritis.
Click to expand...

NewsBot · Feb 20, 2015

A Growing Pains (gp) Questionnaire : Validation And Reliability Control
M Vasilopoulou, E Kritseli, N Myriokefalitakis, M Tsolia
Arch Dis Child 2014;99:A238

Background Growing pains (GP) is a common cause for visiting the paediatrician. Their prevalence remains obscure and a screening questionnaire is not available.

Aim To develop a questionnaire, appropriate for the estimation of GP prevalence in the general children’s population aged 4–7 years old.

Material and methods After review of the literature, a 27–closed type questions with two-answer options (yes-no) questionnaire was developed, including the parameters of localization, duration, intensity and heredity of growing pains. Content validity and test-retest have been examined in a pilot study preceding the present study. The validity of the questionnaire was further studied in a parental population of children aged 4–7 years old, sourced from a randomly selected elementary school in Athens. The reliability was examined by repeated parents response over 3 weeks.

Results 83 questionnaires were filled out. The final version of the questionnaire comprised 21 questions. The mean test-retest reliability was 75.4%, ranging from 0.33–100% (p < 0.001, Cronbach alpha coefficient was equal to 0.68 for total scale, ranging from 0.62–0.82 for the subscales). Construct validity evaluation defined 9 fields incorporating the 21 questions. After excluding low reliability questions, nine items remained in the scale. A cut-off point of ≥8 was finally proposed for the detection and diagnosis of growing pains.

Conclusions We report the development of a reliable and valid questionnaire for GP based on the existing publications. This questionnaire focused on the domains of pain localization, intensity of growing pains and their 24 h temporal distribution.
Click to expand...

Growing pains: twin family study evidence for genetic susceptibility and a genetic relationship with restless legs syndrome.
Champion D, Pathirana S, Flynn C, Taylor A, Hopper JL, Berkovic SF, Jaaniste T, Qiu W.
Eur J Pain. 2012 Oct;16(9):1224-31.

BACKGROUND:
Growing pains (GP) is a prevalent familial childhood disorder of unknown aetiology. Familial occurrence of GP, and individual and familial association of GP with restless legs syndrome (RLS) has been reported.
METHODS:
We applied a twin family design to search for evidence of genetic susceptibility to GP, and for a genetic relationship between GP and RLS. The parents of 1843 twin pairs aged 3-16 years were administered a questionnaire, which identified 88 pairs with at least one twin individual fulfilling criteria for GP. Standard questionnaires for history of GP and RLS were completed for these twin pairs, their siblings and parents.
RESULTS:
Twenty-five of 34 monozygotic (MZ) pairs were concordant for GP, compared with 12 of the 54 dizygotic (DZ) pairs. The casewise concordance was 0.85 and 0.36 for MZ and DZ pairs, respectively (p < 0.001). The lifetime GP prevalence for relatives of twins with GP was 51% for non-twin siblings, 47% for parents. Twenty-three percent of twin individuals with GP met RLS criteria compared with 8% of twin individuals without GP (p = 0.03). Of the twins with GP concordance, 19% met RLS criteria compared with 2% of twins with GP discordance (p = 0.01). In two MZ pairs, one had GP and the other RLS. The lifetime prevalence of RLS was 40% for mothers, and 24% for fathers and 18% for non-twin siblings.
CONCLUSION:
This first twin family study of GP provides evidence for a genetic aetiology and for a genetic relationship to RLS.
Click to expand...

NewsBot · Oct 21, 2014

A New Growing Pains Diagnostic Tool:evaluation In A Mediterranean Clinical Sample
M Vassilopoulou, A Spathis, I Paspati, M Tsolia
Arch Dis Child 2014;99:A567-A568

Background "Growing pains (GP)" is the most common musculoskeletal complaint in childhood.

Aim To investigate the sensitivity and specificity of a previously validated questionnaire, for the diagnosis of GP.

Methods From 01/2013–12/ 2013, a questionnaire (Tb. 1), was administered to parents of children aged 3–8 years,who visited an orthopaedic clinic of a general children’s hospital, as outpatients, complaining of lower limb pain of no apparent traumatic cause. An orthopaedic, blind to the parents’ answers to the questionnaire, evaluated the children. A researcher estimated the score of each one of the completed questionnaires and reviewed the orthopaedics’ clinical chart.

Results 35 questionnaires were completed. According to orthopaedics, 21 children had GP, while according to questionnaire, 13 children did so. When the cut-off point was reset at 7, sensitivity was 91.3% and specificity 95.4%.

Conclusions The questionnaire quantifies parental answers and may assist clinicians in GP diagnosis.
Click to expand...

Admin2 · Oct 21, 2014

For completeness, other threads:
Effect of spinal manipulation on growing pains in children
Growing pains and vitamin D supplementation
Are 'growing pains' and 'restless legs syndrome' the same thing?

drhunt1 · Apr 19, 2015

The differential diagnosis, and the methods by which, not only the pain presents itself, but by the physician's techniques, is critical. For instance, while myelogenous leukemia, neuroblastomas, rhabdomyosarcoma and osteosarcomas are real concerns, for the most part, they present differently than true GPs.

Rhabdomyosarcoma:

http://www.cancer.org/cancer/rhabdomyosarcoma/detailedguide/rhabdomyosarcoma-signs-symptoms

osteosarcoma:

http://kidshealth.org/parent/medical/cancer/cancer_osteosarcoma.html

myelogenous leukemia:

http://www.cancer.gov/cancertopics/pdq/treatment/childAML/Patient/page1

neuroblasomas:

http://kidshealth.org/parent/medical/cancer/neuroblastoma.html#

The key and common finding, if these cancers do present in the LE, is swelling in the limb with pain upon palpation to the swelling. In GPs, there is no swelling or pinpoint pain elicited with palpation to the lower or upper leg. While blood tests and plain film radiographs can be utilized to R/O these rare cancers, (as well as Still's Ds), there is no positive findings from these tests with GPs.

Dr. Hight and myself have made the hypothesis that the majority of GPs is referred from the STJ.

http://www.podiatrym.com/Current_Issue2.cfm?id=1632

Considering the percentages of children that present with pain in their legs at night, we stand by that hypothesis. The only pain that is elicited by the practitioner, is palpation to the sinus tarsi, or posterior facet of the STJ, usually much worse in the afternoon, which resolves after orthotic therapy after the 2nd night of treatment. Much more research needs to be performed on the tie between GPs and RLS, but the authors feel this was a necessary start to the discussion.

NewsBot · Sep 6, 2016

Perinatal Risk Factors and Genu Valgum Conduce to the Onset of "Growing Pains" in Early Childhood.
Kaspiris, A.; Chronopoulos, E.; Vasiliadis, E.
Preprints 2016, 2016080113 (doi: 10.20944/preprints201608.0113.v1).

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is Growing Pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GPs pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them 10 pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. 78 children presented GPs meeting Peterson’s criteria. Genu valgum severity was a significant factor for GPs manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33cm) and birth length or weight (smaller than 50 cm and 3000gr, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive for the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GPs appearance.
Click to expand...

Growing Pains in Children

Ian North Member

Sean Millar Active Member

davidh Podiatry Arena Veteran

admin Administrator Staff Member

Ian North Member

admin Administrator Staff Member

Kevin Kirby MVP

Kevin Kirby MVP

One Foot In The Grave Active Member

Kate Grundy Welcome New Poster

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Freeman Active Member

yvonnespod Member

carol Active Member

Podiatry777 Active Member

Hylton Menz Guest

LuckyLisfranc Well-Known Member

NewsBot The Admin that posts the news.

JFAR Active Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Robertisaacs MVP

Kevin Kirby MVP

NewsBot The Admin that posts the news.

C Johnston Welcome New Poster

NewsBot The Admin that posts the news.

Craig Payne Moderator

CraigT Well-Known Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

drhunt1 Well-Known Member

NewsBot The Admin that posts the news.

Effect of spinal manipulation on growing pains in children

Defining Growing Pains

Leg "Growing" Pains in Congenital Heart Disease

Growing Pains and Restless Leg Syndrome...a pilot study.

Foot orthotics for growing pains

The Myth of Growing Pains

Growing pains

Share This Page

Useful Searches