Anything that keeps children up at night can be stressful for parents! “Growing Pains” is a term used to refer to a common complaint in children. Are Growing Pains (GP) real? Current research theories for GP include a variant of a non-inflammatory pain syndrome, or a local overuse syndrome. Sometimes it is a diagnosis of exclusion, meaning that before we diagnose GP in a child, we first rule out all other possible conditions.

When a child complains of pain, the important thing is to rule out serious pathology and ideally, to get a clear diagnosis. There are some growth-related problems which can occur in children which need to be differentiated from GP in order to correctly manage them - these reasons are why it is important to get your child assessed. if they are complaining of pain.

How do Growing Pains Present?

• Affect the lower limbs

• Symmetrical/bilateral

• No pain to touch

• Intermittent, often presents at night

• Usually pain free on waking

• Orthopaedic examination in the clinic will be negative

In contrast, other lower limb growth related conditions (often affecting where an immature tendon connects to bone) will generally present differently and may:

• Affect upper or lower limbs

• May be unilateral or asymmetrical

• Pain on palpation

• Aggravated by activity, may have a limp

• Can be present on waking

• Pain can generally be reproduced with musculoskeletal or orthopaedic testing in the clinic.

Examples of these lower limb problems called enthesopathies are: Osgood Schlatters (knee), Severs disease (heel), Sinding-larsen-Johansen (kneecap/patella). Conditions that may present in the spine include scoliosis, Scheurmann’s disease, pars defects and spondylolisthesis.

We always take a very thorough medical history and are on the lookout for any “red flags” in the history or examination which may be a sign of more serious pathology that needs further investigation. These include persistent night pain, unexplained weight loss, fever and malaise.

How do we treat growth disorders?

The first step is to confirm a diagnosis so we can determine the most appropriate treatment and management. This often requires some teasing out of information from both the patient (child or adolescent) and parent(s) together. Depending on the diagnosis, we may suggest:

• Rest or a decrease in total activity across the week - it is rare that total rest is needed though sometimes, modification to how much physical activity they do is needed.

• Exercises to strengthen specific muscles and tendons, change. and improve movement patterns and sport specific requirements.

• Education and reassurance around types of pain, negative pain beliefs, coping mechanisms & other lifestyle factors.

• Hands on treatment to address muscular tension, range of motion and compensations.

• Self management strategies - warm ups, cool downs, stretching, post-game techniques and pain relief techniques.

If your child has been complaining of pain for more than a few days, book an appointment with one of our clinicians today.

References:

Evans, A.M. Growing pains: contemporary knowledge and recommended practice. J Foot Ankle Res 1, 4 (2008). https://doi.org/10.1186/1757-1146-1-4

Craft A. Curbside Consult: Do growing pains exist? West J Med. 1999 Jun;170(6):362. PMID: 18751156; PMCID: PMC1305695.

Lowe RM, Hashkes PJ. Growing pains: a noninflammatory pain syndrome of early childhood. Nat Clin Pract Rheumatol. 2008 Oct;4(10):542-9. doi: 10.1038/ncprheum0903. Epub 2008 Sep 2. PMID: 18762787.