Growing Pain
What are Growing Pains?
We have all at some stage heard a parent refer to their child as having 'growing pains'. But what exactly are 'growing pains' and what is the cause and treatment for the pain children feel?
The term 'growing pains' was first described by french physician Marcel Duchamp in 1823, which refers to recurrent leg pain and discomfort in children. Although referred to as growing pain, there is still no evidence to support the link of rapid growth to the pain children suffer. There are also quite a few different and important conditions that must be excluded from a healthcare practitioner before the diagnosis of 'growing pain' can be given.
Many studies have been conducted that have aimed to explore the peak age onset of growing pain, however still to this day there is no clear age bracket for peak onset. In a study by (Kaspiris & Zafiropoulou, 2009) with a sample of 532 Mediterranean children, they found that between the ages of 4-12, there were 130 who had symptoms that were consistent with growing pains within the past year. The average age of the children who had growing pains was 8.6 (with a standard deviation of 2.5 years). Furthermore they found that the discomfort typically began between the ages of 3-6. (Williams, 1928) in a study from the Lancet, investigated and found that the prevalence of growing pains actually decreased as children got older. In an Australian study by (Evans & Scutter, 2004), It was found that the growing pains prevalence in 4-6 year olds was 36.9%. So as can be seen from the above studies, there is no correlation between peak age of rapid growth and 'growing pains'. In fact the pain experienced actually is shown to decrease in prevalence as the child gets older.
So what actually are growing pains and what causes them? Well 'growing pains' are described as recurrent discomfort in the lower extremities, which present bilateral (both sides) and occur late in the day or at night. A study by (Hawkley, 1939) found the pain is typically experienced in the calves, anterior thighs, shins and popliteal fossa (behind the knee). In the small study by (Pavone et al, 2011), growing pains were present daily in 5% of patients, 45% had symptoms weekly, 35% had them monthly and in 15% of patients had pain once every 3 months. Though there is no conclusive evidence for what is the cause of growing pain, some scientific research has supported the 'fatigue theory'. The fatigue theory is separated into muscular fatigue and skeletal fatigue. The fatigue theory also is supported by the observational reports from parents that their child typically experiences worse pain on days they were especially active. The muscle fatigue theory is described by (Al-Khattat & Campbell, 2000) as the sensation of subsequent muscular cramps as a result of muscle fatigue. However it must be stated that this again has not been studied directly and is purely observational from the descriptions in older children, who describe their growing pain as "crampy". The skeletal theory however was studied by (Friedland et al, 2005) who investigated and found 39 patients with growing pain had significantly lower tibial bone density than age matched peers. They came to the conclusion that the combination of activity with decreased bone density may increase the risk of an "overuse syndrome" and therefore contribute to growing pains. There are many theories outside of the fatigue theory for growing pains, however the research is lacking.
If you are asking yourself whether you should bring your child in to investigate the pain they recurrently suffer with. My answer would be to always trust your gut and to always be better safe than sorry. As there are many other painful conditions that present in the growing child, I would book in to see your health professional so they can put your mind at ease with a diagnosis. (Baxter & Dulberg, 1988) state that most cases of growing pains do resolve (without therapy) by adolescence. One small study however found that stretching the muscles of the lower limb was beneficial in the management of growing pains.
I hope from this blog that you have a better understanding of 'growing pains' and would have gained some knowledge to describe to your child what to do and how to best manage it.
References
Al-Khattat A, Campbell J. Recurrent limb pain in childhood (‘growing pains’). Foot. 2000;10:117-123.
Evans AM, Scutter SD. Prevalence of “growing pains” in young children. J Pediatr. 2004;145:255-258.
Hawksley JC. Growing pains in relation to rheumatism. BMJ. 1939;1:155-157.