Growing pains in children – A common complain of every parent

by Dr. Jyothi Raghuram

"Doctor, my 5-year-old daughter cries with leg pains daily – what do I do?"

A common complain that we get to hear from parents. It often prevents the child from falling asleep. Parents are concerned that the child is in distress due to pain and are unsure what the cause may be. They do not want to medicate frequently, but as the child is fine by morning, they are uncertain if any tests are required. In most cases, this is due to what is commonly referred to as Growing pains.

'Growing pains' – a term used for the recurrent pain in lower limbs seen in pre-school and school-aged children, are a misnomer as it has does not coincide with the peak growth period. The pain generally is in both legs in evenings and nights and gets better with a massage. The pain may be in calf muscles or the back of knees or thighs.

It may occur daily or may recur every few days or weeks. It may be more on some days when the playtime or exercise was excessive. Typically, the child is always well in the morning when she wakes up and remains active throughout the day. A more appropriate term would be 'Benign nocturnal pains of childhood,' benign indicating no serious underlying cause for the pain.

Nearly 10%-20% of school-aged children can have growing pains. The frequency of the pain decreases with increasing age but may continue until the child is 10-12 years old. A visit to the local top children's hospital in Whitefield may help rule out any other cause and allay anxiety if frequent or severe.

Growing pains is a clinical diagnosis made based on history and thorough physical examination. Sometimes children may have excessively lax ligaments (loose-jointed), called Joint hypermobility, and such children are known to have more incidence of Growing pains. A simple joint examination is sufficient to ascertain if the child has Joint hypermobility or not.

No tests are needed. Many parents want to know if this could be due to Vitamin D deficiency and whether it needs to be checked. While Vitamin D deficiency may be associated (it is common in our country despite there being much sunshine), this is not the cause for growing pains, and parents should not expect that giving Calcium or Vitamin D supplements will relieve pain. Treatment is only massage, reassurance and if the pain is severe, Paracetamol will suffice.

However, it is essential to check with your doctor if any of these symptoms are present (what we call Red Flag signs) - fever, weight loss, night sweats, ‘night cries’ (the pain wakes up the child from deep sleep), any joint or limb swelling, pain in only one particular joint always or is limping when she wakes up in the morning. It is NOT a case of simple growing pains in any of these cases, and such a child will need a thorough physical examination and further investigations to rule out more serious causes like cancer, arthritis, bone problems, etc.

Dear parents, I hope the above information was helpful!

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