Several years ago, my eldest son, then 13 years of age, began to complain of a nagging pain in his right leg just below the knee. I took little notice of this putting it down to the usual bumps and bruises that boys will get through the years. It was not until my boy had been limping on the leg for several weeks that I really began to sit up and take notice. When I examined the leg a firm lump had appeared just below the knee that was quite painful to touch. The next day an x-ray revealed an odd looking mass, the examining (junior) doctor shared my gut wrenching opinion that it could well be a malignant growth. I lived a nightmare for the next 24 hours until the final diagnosis was made. Oschgood Schlatter disease, a relatively common condition occurring particularly in young boys, when the strong hamstring muscle pulls on the immature growth plate of the long bones, causing the growth plate to buckle, and swell. This is but one reason that youngsters suffer from limb pain.
Between about 10% and 18% of children and young people have pain in the limbs, usually the legs, which does not seem to have any physical cause. Usually this pain comes and goes for a few years and then disappears by about mid adolescence. The pain can be quite mild or bad enough to upset the child’s sleep.
Note - Any pain which persists or where there is swelling, feeling unwell, fever, or any difficulty in movement should be checked by a doctor. There is a danger that a serious cause may be overlooked if pain is just thought to be growing pains.
WHAT ARE GROWING PAINS?
It is doubtful that growing pains have anything to do with growth as growth occurs too slowly (even in growth spurts) to be the cause of pain.
Growing pains often start between 3 and 5 years of age or during the early years of school and may continue into adolescence - often lasting for several years on and off. They cease by mid adolescence, they affect about the same number of boys and girls, and there are no long term health problems from growing pains.
CAUSES
No clear cause has been found for growing pains. In some cases they may be associated with:
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being very tired from over exercising
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emotional stress or unhappiness
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postural problems (not standing, sitting or walking well).
(None of the above, nor any other causes have been clearly proven by research to cause the pains).
SYMPTOMS OF GROWING PAINS
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pain or ache that comes and goes, usually in the muscles of the calves and thighs or behind the knees, occasionally in the arms - not in the joints. It usually does not happen every night
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the pain is often described as an ache, but can be severe enough to wake children from sleep
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the pain often comes in both legs whereas pain that is related to an underlying physical problem is more likely to be in one limb
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growing pains usually come in the evening or at night and are usually gone in the morning
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there may also be feelings of restlessness
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growing pains do not affect movement or general health and do not cause swelling
OTHER CAUSES OF PAIN
Children with pain should be seen by a doctor to make sure there are no serious causes such as injury, infections (including viral infections and osteomyelitis), arthritis (including juvenile rheumatoid arthritis), malignancy (osteosarcomas), gait disorders (eg excessively flat feet) or other physical problems, especially if the pain:
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is causing a limp
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involves the joints (eg knees, ankles)
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is severe
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is persistent, including still being there during the day time
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occurs with fever or other signs of illness such as tiredness and loss of appetite etc
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or if there is swelling or the area is red or hot or sore to touch
WHAT YOU CAN DO.
This should be related to what helps the child feel better. Some or any of the following may help:
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gentle massage
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heat such as a hot water bottle
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paracetamol could be tried if the child cannot sleep.
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reassurance
Should you be concerned at all about your childs limb pain have your child checked by an experienced pediatric doctor.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
