Growing Pains

Abstract

Context:The term growing pains describes a common, benign syndrome of recurrent discomfort that occurs in young children. First described in the 1800s, the etiology of this condition remains unclear. The peak incidence does not correspond to a time of rapid growth. Children typically report bilateral pain in the lower extremities that occurs late in the day or at night.Evidence Acquisition:The PubMed database was searched using the keywords growing pains, benign nocturnal limb pains of childhood, recurrent limb pain of childhood, and limb pain in childhood. Articles were also found by reviewing references from the initial PubMed search. Only English-language articles published from 1900 through 2016 were included in the review.Study Design:Clinical review.Level of Evidence:Level 3.Results:When a patient’s history is classic for growing pains and physical examination is normal, laboratory and radiographic evaluation are not needed to make the diagnosis. Findings typical for growing pains include bilateral lower extremity pain usually experienced in the early evening or at night. The pain is not caused by activity and will not cause a limp.Conclusion:Additional workup is warranted for children with an atypical history, systemic symptoms, or for those individuals with physical examination abnormalities such as allodynia, focal tenderness, joint swelling, or decreased joint range of motion. Management of growing pains generally consists of symptomatic care with massage and over-the-counter analgesics, as well as reassurance to children and parents about the benign, self-limited nature of this condition. This review article summarizes data on the epidemiology, etiology, and management of growing pains and provides a framework for distinguishing this entity from other causes of extremity pain.

Consensus recommendations for diagnosis, management and treatment of Fabry disease in paediatric patients

“…Growing pains can be further differentiated from FD pain by assessing when and where the pain occurs: FD pain is most frequently experienced as burning, stabbing, tingling or shooting pain in the hands and feet and occurs during the day, particularly in late morning. In contrast, growing pains usually occur in the lower extremities during the late evening and night . In addition to neuropathic pain, children with FD often experience GI symptoms such as abdominal pain and diarrhoea .…”

Differenzialdiagnostik nicht-entzündlicher Gelenkschmerzen/-schwellungen bei Kindern und Jugendlichen

“…Die sicherlich häufigste aseptische Knochennekrose ist gekennzeichnet durch Schmerzen über der Tuberositas tibiae, wo es vermutlich aufgrund von wiederholten Zugtraumata als Überlastungssyndrom zu einer Apophysitis der Wachstumsfuge kommt [2]. Sie tritt häufig bei sportlich aktiven Patienten im Alter von 10 bis 15 Jahren auf, bevorzugt bei männlichen Patienten.…”

“…Wachstumsschmerzen, oder ‚benign nocturnal limb pain in childhood' sind die häufigste Ursache episodischer muskuloskelettaler Schmerzen in der Kindheit, die etwa ein Viertel aller Kinder im Schulalter betreffen [2]. Die Ursache ist unbekannt, aber eine transiente Schmerzverstärkung wird vermutet [27].…”

“…muskuloskelettaler Beschwerden ist häufig sofort ersichtlich, während die Ursache von chronischen Schmerzen und/oder Schmerzen mit begleitenden Symptomen meist schwieriger festzustellen ist. Kinder mit ernsthaften rheumatischen oder sogar bösartigen Erkrankungen können durchaus als ‚Wachstumsschmerzen' verkannt werden [2]. Kinder mit ungewöhnlichen muskuloskelettalen Beschwerden oder Befunden sollten dementsprechend sorgfältig abgeklärt werden.…”

Growing pains: What do we know about etiology? A systematic review

“…French physician Marcel Duchamp first described growing pains as a recurrent leg pain syndrome of early childhood[1]. No evidence has linked growing pains with a phase of especially high growth velocity, which has led physicians to coin new terms for this condition, including “benign nocturnal limb pains of childhood” and “recurrent limb pains of childhood”[2]. However, the term “growing pains” still remains the most commonly used since it has the advantage of not implicating any particular disease and also emphasizes childhood as the period when these pains are most common[3].…”