Paging Dr. Frischer - Growing Pains

Your child wakes up in the middle of the night complaining of unexplained leg pains. What is going on? Is there such a thing as growing pains?This is actually a common complaint, and doctors have a name for it: "Non-specific limb pains of childhood." It appears to occur in about 25% to 40% of children between the ages of 2 to 17. At some point after puberty, it stops as growth stops. The pain is described as mild to moderate in nature, rarely intense, usually in one leg but often in both, and most often late in the day or at night. Growing pains are often described as an ache or throb - often in the front of the thighs, the calves or behind the knees. They can last up to 15 minutes, typically don't interfere with daytime activity, and do not result in permanent harm. What causes the pain? Some theories suggest that the pain is simply from the typical jumping, running and climbing of children that result in muscular injury, strain or tears. Other research indicates that the pain is similar to shin splints (pain along the shins) which can be a sign of overused muscles, stress fractures of the lower leg bones, or muscle and tendon stress caused by flat feet. The pain concentrates in the muscles rather than the joints. The child's size doesn't seem to matter, or their rate of growth. The intensity of the pain varies from child to child, and most don't experience the pains every day. Growing pains are considered a diagnosis of exclusion - that is, the diagnosis is what's left once other conditions have been ruled out. Technically, "growing pains" is not a disease. There is no hard evidence that growth causes pain. However, in the absence of an alternative explanation, most in medicine recognize it as a condition. Your child's doctor will conduct a thorough history and physical examination, and if possible, note how the child responds to touch while in pain. Those in pain from many other conditions generally don't like contact because movement tends to increase the pain. But those with growing pains respond differently - they feel better when they're held, massaged, and cuddled. In rare instances, blood tests and X-ray studies are performed before a final diagnosis of growing pains is made. How do we treat growing pains? There is no specific treatment. Massage, heat, ice, topical creams, or over-the-counter pain medications can be used to alleviate symptoms. With simple growing pains, there is no need to worry, as they do go away. Consult your child's doctor if you're concerned about your child's pain, or if there is: Persistent pain that continues into the morning Swelling or redness in one particular area or joint Severe enough pain to interfere with normal activities Pain associated with a particular injury Pain accompanied by other signs or symptoms, such as tenderness, fever, limping, rash, loss of appetite, weakness or fatigue, or the urge to move the leg. I wish your young loved ones happy, pain-free growing! Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: April 12, 2012 - Volume 10 - Issue 52