Growing pains in children

Growing pains

Universally ,children in their growing years typically complain of a characteristic pain in their legs at night during their growth spurts - known as the growing pains. Growing pains are noted to have the following typical characteristics:

Occurs in children in the age group of 3 to 12 years. By teenage, most children have outgrown the pain. Some suggest that the condition peaks at two vulnerable age groups- among 3 to 5 year olds and 8 to 10 year olds.
The pain appears in the late evening or more commonly at night, waking up the child.
Pain may be mild but can be severe.
Commonly felt in the shin, calf, thighs or sometimes behind the knee, almost never in the joint.
An episode may last from a few minutes to a couple of hours.
Child is totally pain free the following day- may be fatigued due to lack of sleep the previous night.
The episodes are punctuated by pain free periods that may last from weeks to months.
Growing pain is almost always bilateral affecting both legs.
Pain is relieved by massaging, stretching or moist heat and pain killers like acetaminophen.
Despite the typical features, the cause of growing pain has not yet been found out. Current knowledge about the cause and course of the pain is largely based on experiences, as only very few studies are done on this topic.

Why do some kids get growing pains while others do not?

As already mentioned previously, the causes of growing pains are not very obvious. The proposed causes (according to studies by Dr.Yosef Uziel and Dr. Philip J Hashkes) are

Low pain tolerance: Kids with growing pains exhibited a lower pain tolerance when compared to controls.
Overuse: Kids who reported growing pains were overactive, when compared to other kids. Also parents note that when a kid has had an exhausting day, he is more likely to complain pain that night. It is not recommended to make such children to slow down so as to prevent growing pains, though.
Bone strength density : Children suffering from growing pains are found to have a low bone strength density. This along with overuse and hyperactivity is likely to cause pain.
Mechanical strain :Many children with growing pains are found to have flat foot with mild outward turning of back of foot. This could cause increased strain during activity leading on to pain.
Although the quality of life is similar to other kids, it is suggested that family environment , stress and psychological disposition often can contribute to pain. Parents note that the kid is more likely to complain of pain, when he has been mentally upset.
Other proposed causes are that the bone growth often slightly exceeds the muscle growth leading on to tightness of muscles and tendons. It has also been noted that the children with growing pains are slightly on the heavier range.

What is not growing pain?

It is very important not to miss any disease which also can present as leg pain. The following are the warning signs that clue you that the pain is not just a 'growing pain'.

If the pain is persistent or occurs even during daytime.
If the pain is increased on handling or movement. In growing pain, the child is comforted by massaging or patting his legs.
If the pain is localised in a joint, other diagnosis such as childhood arthritis should be considered, as growing pains practically never affect joints.
If the child develops a limp while walking.
If the child runs a temperature, it may signal infection and will need a thorough check up and tests.
If the child has or develops a rash.
If the child develops pain in only one leg consistently or if there is a wound, bruise or redness.
Limb weakness.
Under the above said situations, it is advisable to visit your paediatrician.Also visit your doctor, if you are getting stressed out about your child's complaint or if it starts affecting your quality of life.

What will the doctor do?

From their experience , most doctors can pick out 'growing pain' and will be able to reassure you and put your worrying mind to rest. If the doctor is not convinced about the nature of the pain or if there are other worrying symptoms, he may want to rule out other conditions like trauma, tumor, arthritis, infection etc. For this, he may order tests like x ray, bone scan, blood tests etc.

Can I prevent these pain episodes?

Nothing much could be done to prevent growing pains. Some parents say that they can prevent an episode by predicting it when the child is having a physically demanding day and by giving painkillers in advance.

Treatment:

A child crying with pain in the middle of the night can be very stressful for the parents and the child.
The child with mild pain can be comforted by helping him to stretch out his legs, gentle massaging and by applying moist heat, (along with plenty of cuddling of course).Children with more intense pain may be given painkillers like acetaminophen or ibuprofen. (Do not give aspirin to children as it can cause a rare but potentially fatal condition called 'Reye's syndrome).

Remember:

Growing pain is the most common pain disorder that presents to a paediatrician and it affects as much as 3 to 40% of children in their growing years.
Visit the paediatrician if you are worried about your child's pain. Know the warning signs.
Growing pains are part and parcel of childhood and sooner than you realise your clingy little child will turn in to a tall and shy teenager and the pain episodes will be a memory of the past.