An Article Written By Shaun Vu
Podiatrist – New Step Podiatry
This blog article is about how to make growing pains less painful for not only kids but for their parents and guardians. What is growing pains and how to identify growing pains is first discussed. Tips on how to make growing pains less painful are provided.
What are growing pains?
Growing pains, also known as Benign nocturnal limb pains (BNLP), are non-specific leg pains which affect otherwise healthy and normal children.
The cause is not directly understood but we know that the problem goes away with time.
The pain might be associated with muscle fatigue, bone fatigue and might be a mild pain syndrome of the nerves. Most affected children have an affected 1st degree relative so there might be a genetic predisposition.
Growing pain episodes tend to occur in clusters and they are not directly associated with growth in many children. The most robust research demonstrated that approximately 37% of children aged four to six years experience growing pains.
How do you know if your child is experiencing growing pains?
– The pain is intermittent- there are some pain free days.
– It can be either leg and can alternate on different occasions.
– The child would feel pain in muscles at the front of the thigh, calf or back of the knee and can be described in vague locations.
– The pain is present in late afternoon or evening.
– Physical examination, lab tests and daily activity are all normal.
– Age ranges between 3-11 but is more common in the middle of that range.
– It is self-limiting however we do not know when the pain will fully resolve. They tend to last for months and come in waves at random.
– They can occur in kids with high activity levels.
Rules of growing pain
How would you know if it is NOT growing pains?
The pain is:
– persistent with increasing intensity.
– predominantly unilateral.
– present in joints.
– still there in the morning.
– On physical examination the area is red, swollen, reduced range of motion.
– There are abnormal laboratory findings.
– Daily activities is restrictive for the child.
If your child is experiencing any of these symptoms, please see a Podiatrist or General Practitioner.
How do podiatrists diagnose growing pain and what can a Podiatrist do for growing pains?
There is unfortunately no single diagnostic in clinic tests however clinical questioning is really important to rule out other conditions.
Recommend preventative stretching (quadriceps, hamstrings and calf muscle stretching program). Morning and evening, both legs. Bed-based parent-assisted stretching for very young children e.g. 4 years old.
Hot tip: the best time to do it is after bathing when the child is warm and relaxed or straight after school. The stretching helps to prevent ongoing growing pains.
If growing pains occur, stretch during the episode, then use other treatments that are found to soothe the child, e.g. leg rub massages, warm water bottle or paracetamol.
How to monitor the effectiveness of this treatment?
Keep a diary of pain episode frequency. You could include a severity scale, e.g. Wong-Baker FACES, either child or parent rated.
References
Evans, A. M. (2008). Growing pains: contemporary knowledge and recommended practice. Journal of Foot and Ankle Research, 1(1), 4–4.
https://doi.org/10.1186/1757-1146-1-4
https://arthritisaustralia.com.au/types-of-arthritis/growing-pains-benign-nocturnal-limb-pai ns-bnlp/
