Somatosensory test responses in children with growing pains

Abstract

PurposeTo further the understanding of growing pains (GP), in particular, the nature of this pain disorder.MethodsThis study included 33 children aged 5–12 years who met criteria for GP (cases) and 29 children without GP of similar age and sex (controls). Nineteen controls were siblings of cases. GP was diagnosed by standard consensus questionnaires. A questionnaire addressed characteristics of the pain and family history of GP. Evidence for peripheral neuropathic disorder was tested by somatosensory testing and provocation tests of peripheral nerves. Somatosensory testing by a blinded researcher involved threshold determination and/or response magnitude to nonpainful stimuli including touch, dynamic brush, cold, vibration, and deep pressure applied to limb and abdominal sites.ResultsDistributional, temporal, and quality characteristics of the pain were in accordance with published descriptions. There was no indication of primary musculoskeletal disorder. No evidence was found that GP is a peripheral neuropathic pain syndrome. There were minor but statistically significantly increased responses to cutaneous cold, vibration, and to deep pressure stimuli in cases compared to controls, evident in a wider distribution than the symptomatic lower limbs.ConclusionGP is a regional pain syndrome with evidence in this study of mild widespread disorder of somatosensory processing.

Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility

“…The broad objective of this study was to improve a clinician's ability in research and practice to characterize the sensory phenotype of chronic pain beyond "tenderness" with a view ultimately to better management. Feasibility of the test procedures have been established and extensive regional hypersensitive and hyposensitive cutaneous abnormalities and low pressure pain thresholds were observed [4,5]. Low pressure pain threshold predicted worst pain intensity [4], consistent with other pediatric pain studies ( Supplementary Table S1).…”

“…The SST protocol was derived from published QST and SST protocols and our previous pediatric studies [4,5] and is summarized in Table 2. The instruments are pictured in Figure 1 and the sources listed in Supplementary Table S3.…”

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

“…Statistically higher levels of lead and zinc were demonstrated in children with growing pains in comparison to healthy controls. Pathirana et al[37] investigated whether growing pains might be associated with some widespread disorders of somatosensory processing. There was no clinical evidence of a peripheral neuropathic pain syndrome and no significant differences in somatosensory test responses between cases and controls at all the tested sites.…”

“…In the same way, despite some electrolyte alterations having been found among children with growing pains[36], the importance of these results still remains to be investigated further. The pain threshold and the somatosensory response to various non-painful stimuli were tested in children suffering from growth pains[37]. In affected children, the response to some of these stimuli was found to be slightly diffuse rather than specifically localized in the lower limbs compared to healthy controls[37].…”

“…The pain threshold and the somatosensory response to various non-painful stimuli were tested in children suffering from growth pains[37]. In affected children, the response to some of these stimuli was found to be slightly diffuse rather than specifically localized in the lower limbs compared to healthy controls[37]. This evidence has led to the idea that growing pains might be a regional pain syndrome in which a slight diffusion disorder of the somatosensory processing might be found[37].…”