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29 Jan 2010 06:00
They are healthy and energetic by day and the same thing never happens to their younger brother.
Our general practitioner diagnosed ‘growing pains”, and their granny remembers their father suffering the same problem, which is reassuring.
But these episodes can be dramatic and disrupt sleep for the whole family.
When you look up ‘growing pains” online or in child health books, the information is infuriatingly vague. Some experts advise ‘cuddles” as the solution. But when our GP referred my daughter to a consultant paediatrician to rule out ‘other things”, this all became alarming.
Google ‘paediatric leg pain” and you are instantly catapulted into the realm of arthritis and leukaemia. Fortunately, our daughter did not have anything of the sort.
Yet, this experience is common and parents can be understandably spooked by their children’s mysterious symptoms. Growing pains affect about 40% of children to varying degrees.
‘There is a lot of confusion among doctors over how to diagnose them,” says Helen Foster, professor of paediatric rheumatology at Newcastle Hospital, in northeast England.
Many GPs, for instance, admit they do not have enough expertise when it comes to spotting musculoskeletal conditions in children, which can be confused with growing pains. Nobody knows why they happen.
But one thing is clear: they have nothing to do with growth. Children grow maximally as babies or during adolescence, but these are not times when you get growing pains.
‘It’s a total misnomer,” says Foster. ‘The term has stuck because it is just easier to remember than its medical name, ‘benign idiopathic nocturnal limb pains of childhood’. Growing pains is really just a label covering all sorts of uncertainties.”
Doctors do know that the pains are not linked to dietary deficiency or growth problems. They seem more common in active children and children with hypermobile joints. And they tend to run in families.
The pains usually affect healthy children between the ages of three and 13 and they always happen at night—never at the start of the day, after waking.
They are intense and crampy, affecting both legs symmetrically (though not always at the same time), usually the calf, shins or ankles, and are not limited to the joints. But they will not cause the child to limp. A whole raft of other illnesses can be confused with growing pains.
‘A lot of children with conditions such as arthritis are initially dismissed as having growing pains,” says Foster. In fact, pain in the limbs of young children can be a sign of serious problems including chronic rheumatic disease, inflammatory muscle disease, childhood arthritis, leukaemia and sepsis.
‘It’s important to know that in all these cases there will be other indicators that the child is not right,” says Foster. ‘But early diagnosis of some of these conditions can make a big difference to outcomes, so it’s never a bad idea to rule things out.”
Even without other symptoms, there is no shame in taking a child with growing pains to the GP. Your child should definitely see a doctor if there is any joint swelling or the pain is in only one leg, or if your child experiences pain in the arms or back, fever, loss of appetite or weight loss.
This is also true if the pain occurs every night and there is a reluctance to walk or limping, especially in the mornings.
Parents who suffer from restless leg syndrome (RLS)—which causes leg discomfort and the uncontrollable urge to move their legs—may wonder whether their child’s discomfort is a sign that he or she, too, is developing this condition.
‘In RLS there is a very definite family link,” says Dr Julian Spinks, a GP with a special expertise in growing pains. Some studies have suggested a link between growing pains and RLS and doctors are investigating whether growing pains could even be a precursor to RLS.
However, says Spinks: ‘At the moment a link is not clear. It’s very difficult to know whether you are dealing with two separate diseases, or whether a child’s ‘growing pains’ are actually the very early stages of RLS.”
Meanwhile, what can you do to help when your child regularly wakes in agony?
Try a firm massage of the lower leg muscles and joints, with paracetamol or ibuprofen when the pains happen.
Keeping a diary could help establish what activities could be a trigger. And Foster recommends prophylactic pain relief, if you can predict an episode.
Supportive footwear—trainers with arch supports and Velcro fastenings—might help too. If all else fails, take consolation in the fact that growing pains won’t go on for ever.—
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