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Growing pains: Practitioners’ dilemma

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Abstract

Need and Purpose of Review

Though cases of ‘growing pains’ are quite common in pediatric practice, very little attention has been given to it, even in the standard text books. The resultant confusion among practitioners regarding diagnosis and management of this condition needs to be addressed.

Methods used for locating, selecting, extracting and synthesizing data

PubMed search was performed using “growing pains “[All Fields] AND ((“child”[MeSH Terms] OR “child”[All Fields] OR “children”[All Fields]) AND (“pediatrics”[MeSH Terms] OR “pediatrics”[All Fields] OR “pediatric”[All Fields])). Types of articles included are Review articles, Systemic Reviews, Randomized Controlled Trials, Practice guidelines and Observational studies. Google Scholar was also searched using the term “Growing pains in children”. Relevant articles not included in the PubMed results were selected. Reference lists of selected studies were also screened to identify additional studies.

Main conclusions

A fairly accurate diagnosis of ‘growing pains’ can be made clinically, if the widely accepted diagnostic criteria are followed. A systematic approach, with due consideration of both inclusion as well as exclusion criteria, can avoid unnecessary (sometimes potentially harmful) investigations and medications. Reassurance remains the main stay in the management of ‘growing pains’.

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References

  1. Anthony K, Schanberg L. Musculoskeletal Pain Syndromes. In: Kliegman R, Stanton B, Geme III J, Schor N, Behrman R, editors. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders; 2011.P. 878.

    Google Scholar 

  2. Uziel Y, Hashkes PJ. Growing pains in children. Pediatr Rheumatol Online J. 2007;5:5. Available From: URL: http://www.ped-rheum.com/content/5/1/5 . Accessed October 10, 2013.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Evans AM. Growing pains: contemporary knowledge and recommended practice. J Foot Ankle Res. 2008;1:4.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Naish JM, Apley J. ‘Growing pains’: A clinical study of non-arthritic limb pains in children. Arch Dis Child. 1951;26:134–140.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Petersen H. Growing pains. Pediatr Clin North Am. 1986;33:1365–1372.

    Google Scholar 

  6. Asadi-Pooya AA, Bordbar MR. Are laboratory tests necessary in making the diagnosis of limb pains typical for growing pains in children? Pediatr Int. 2007; 49:833–835.

    Article  CAS  PubMed  Google Scholar 

  7. Lowe RM, Hashkes PJ. Growing pains: a noninflammatory pain syndrome of early childhood. Nat Clin Pract Rheumatol.2008;4:542–549.

    Article  Google Scholar 

  8. Weiser P. Approach to the patient with noninflammatory musculoskeletal pain. Pediatr Clin North Am. 2012;59:471–492.

    Article  PubMed  Google Scholar 

  9. Foster HE, Boyd D, Jandial S. Growing Pains: A Practical Guide for Primary Care. Arthritis Research UK. Available from URL: http://www.arthritisresearchuk.org/healthprofessionals-and-students/reports/hands-on/hands-onautumn-2008.aspx. Accessed December 21, 2013.

  10. Brindani F, Francesca, Franco G. Restless leg syndrome: differential diagnosis and management with pramipexole. Clin Interv Ageing. 2009;4:305–313.

    CAS  Google Scholar 

  11. Rajaram SS, Walters AS, England SJ, Mehta D, Nizam F. Some children with growing pain may actually have restless leg syndrome. Sleep. 2004;27:767–773.

    PubMed  Google Scholar 

  12. Evans AM, Scutter SD. Prevalence of “growing pains” in young children. J Pediatr. 2004;145:255–258.

    Article  PubMed  Google Scholar 

  13. Oster J, Neilsen A. Growing pains: clinical investigation of a school population. Acta Pediatr Scand. 1972;61:329–334.

    Article  CAS  Google Scholar 

  14. Abu-Arafeh I, Russel G. Recurrent limb pain in school children. Arch Dis Child. 1996;74:336–339.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Kaspiris A, Zafiropoulou C. Growing pains in children: Epidemiological analysis in a Mediterranean population. Joint Bone Spine. 2009;76:486–490.

    Article  PubMed  Google Scholar 

  16. De Piano LPA, Golmia RP, Golmia APF, Sallum AME, Nukumizu LA, Castro DG, et al. Diagnosis of growing pains in a Brazilian pediatric population: a prospective investigation. Einstein. 2010;8:430–432.

    Google Scholar 

  17. Saha SK, Modak A, Chowdhury K, Uddin MS, Ghosh D, Al-Mamun MA. Diagnosis of growing pain in Bangladeshi pediatric population. J Shaheed Suhrawardy Med Coll. 2013;5:46–48.

    Google Scholar 

  18. El-Metwally A, Salminen JJ, Auvinen A, Kautiainen H, Mikkelsson M. Lower limb pain in a preadolescent population: prognosis and risk factors for chronicity — a prospective 1- and 4 -year follow-up study. Pediatrics. 2005;116:673–681.

    Article  PubMed  Google Scholar 

  19. Uziel Y, Chapnick G, Jaber L, Nemet D, Hashkes PJ. Fiveyear outcome of children with growing pains: Correlation with pain threshold. J Pediatr. 2010;156:838–840.

    Article  PubMed  Google Scholar 

  20. Pavone V, Lionetti E, Gargano V, Evola F, Costarella L, Sessa G. Growing Pains: A study of 30 cases and a review of literature. J Pediatr Orthop. 2011; 31:606–609.

    Article  PubMed  Google Scholar 

  21. Duchamp M. Maladies de la Croissance. In: Levrault FG, editor. Mémoires de médecine practique. Paris: Jean- Frédéric Lobstein; 1823.

    Google Scholar 

  22. Leung A, Robson W. Growing pains. Can Fam Physician. 1991;37:1463–1467.

    CAS  PubMed Central  PubMed  Google Scholar 

  23. Bennie PB. Growing pains. Arch Pediatr. 1894;11:337–347.

    Google Scholar 

  24. Sheldon, W. In: Diseases of Infancy and Childhood, London: Churchill; 1936.

    Google Scholar 

  25. Hawksley JC. The nature of growing pains and their relation to rheumatism in children and adolescents. BMJ.1939;1:155–157

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Evans AM. Relationship between growing pain and foot posture in children: single case experimental design in clinical practice. J Am Pediatr Med Assoc. 2003;93:111–117.

    Google Scholar 

  27. Evans AM, Scutter SD. Are foot postures and functional health different in children with growing pains? Pediatr Int. 2007;49:991–996.

    Article  PubMed  Google Scholar 

  28. Viswanathan V, Khubchandani RP. Joint hypermobility and growing pains in school children. Clin Exp Rheumatol. 2008;26:962–966.

    CAS  PubMed  Google Scholar 

  29. Apley J. Clinical Canutes. A philosophy of paediatrics. Proc R Soc Med. 1970; 63:479–484.

    CAS  Google Scholar 

  30. Haskesh PJ, Friedland O, Jaber L, Cohen A, Wolach B, Uziel Y. Decreased pain threshold in children with growing pains. J Rheumatol. 2004;31:610–613.

    Google Scholar 

  31. Pathirana S, Champion D, Jaaniste T, Yee A, Chapman C. Somatosensory test responses in children with growing pains. J Pain Res. 2011;4:393–400.

    PubMed Central  PubMed  Google Scholar 

  32. Aeschlimann FA, Werner H, Jenni OG, Saurenmann RK. Are growing pains a parasomnia. Pediatr Rheumatol. 2012;10:A78.

    Google Scholar 

  33. Lech T. Lead, copper, zinc, and magnesium levels in hair of children and young people with some disorders of the osteomuscular articular system. Biological Trace Element Res. 2002;89:111–125.

    Article  CAS  Google Scholar 

  34. Golding J, Northstone K, Emmett, Steer C. Do ù-3 or other fatty acids influence the development of growing pains? A pre-birth cohort study. BMJ Open. 2012;2:e001370.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Goodyear-Smith F, Arrol B. Growing pains. parents and children need reassuring about this self-limiting condition of unknown cause. BMJ. 2006;333:456–457.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Baxter MP, Dulberg C. Growing Pains in childhood — A proposal for treatment. J Pediatr Orthop. 1988;8:402–406.

    Article  CAS  PubMed  Google Scholar 

  37. Rathi N, Rathi A. Vitamin D and child health in the 21st century. Indian Pediatr. 2011;48:619–625.

    Article  PubMed  Google Scholar 

  38. Qamar S, Akbani S, Shamim S, Khan G. Vitamin D levels in children with growing pains. J Coll Physicians Surg Pak. 2011;21:284–287.

    PubMed  Google Scholar 

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Correspondence to Mahesh Prasad Mohanta.

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Mohanta, M.P. Growing pains: Practitioners’ dilemma. Indian Pediatr 51, 379–383 (2014). https://doi.org/10.1007/s13312-014-0421-0

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