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Growing Pains in Children

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  #1  
Old 6th December 2004, 07:41 PM
Ian North Ian North is offline
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Default Growing Pains in Children

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Recent Article in the Journal of Pediatric Orthopaedics.

Growing Pains: Are They Due to Increased Growth During Recumbency as Documented in a Lamb Model?
Noonan, Kenneth J. MD; Farnum, Cornelia E. DVM, PhD; Leiferman, Ellen M. DVM; Lampl, Michelle MD, PhD; Markel, Mark D. DVM, PhD; Wilsman, Norman J. DVM, PhD
Journal of Pediatric Orthopedics. 24(6):726-731, November/December 2004.
Quote:
The rate and patterns of longitudinal bone growth are affected by many different local and systemic factors; however, uncompromised growth is usually considered to be smoothly continuous, with predictable accelerations and decelerations over periods of months to years. The authors used implanted microtransducers to document bone growth in immature lambs. Bone length measurements were sampled every 167 seconds for 21 to 25 days. The authors show that at least 90% of bone elongation occurs during recumbency and almost no growth occurs during standing or locomotion. The authors hypothesize that growth may also occur in children during rest or sleep, thus supporting the concept of nocturnal growth and perhaps a relationship to growing pains.
The authors suggest the growth plates are compressed during weightbearing.
" A possible mechanism of pain may result from increased tension in the periosteum as the growth plates sping back from released compression or by some signal transduction mechanism during recumbency."

With the successful use or orthoses and triplanar wedges in the reduction of symptoms associated with "growing pains", or lower leg aches are we seeing a mechanical affect on the bones/growth plates or simply reducing muscle fatigue ???

Thoughts ???

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Old 6th December 2004, 10:58 PM
Sean Millar Sean Millar is offline
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Could it be that wedges and other biomechanical foot devices reduce periosteal tension/tugging, therefore reducing overall stress/inflammation experienced during periosteal growth phases.
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Old 7th December 2004, 02:47 AM
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Quote:
Originally Posted by Ian North
With the successful use or orthoses and triplanar wedges in the reduction of symptoms associated with "growing pains", or lower leg aches are we seeing a mechanical affect on the bones/growth plates or simply reducing muscle fatigue ???

Thoughts ???
Bit of both, I would have thought :) .
A search on "growing pains" will reveal several theories, only one of which is described in this article.
Regards,
David
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Old 7th December 2004, 11:14 PM
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Relationship Between "Growing Pains" and Foot Posture in Children Single-Case Experimental Designs in Clinical Practice
Angela M. Evans
Quote:
Many young children present to the podiatric physician with the complaint of aching legs. Many of these children are clinically assessed as having a pronated foot posture. This foot posture is thought to be deleterious and is often treated with in-shoe devices such as triplane wedges or orthoses. Intervention aiming to reduce the amount of foot pronation in both stance and gait has been reported by parents and children to reduce, and in many cases eliminate, the episodes of aching legs. To test this theory and establish a degree of causality, a single-case experimental design was used in conjunction with age-appropriate pain scores for the children and independent parental ratings. Single-case experimental design is a useful research tool for the clinical practice setting that can identify cause-effect relationships and obviates large sample sizes. Eight complete single-case experimental designs were performed in the clinical setting. The in-shoe intervention proved efficacious for children with a pronated foot posture and aching legs. These findings may provide the impetus for a more rigorous examination of the possible relationship between pronation and "growing pains." (J Am Podiatr Med Assoc 93(2): 111-117, 2003)
Growing pains affecting one in three young children
By Geraldine Hinter

Quote:
Growing pains are a bigger problem for young children than first thought, affecting one child in every three, a UniSA study shows.

Parents of children aged between four and six from across South Australia took part in the study by completing questionnaires on the prevalence of growing pains in their children.

This is the first time that research has focused specifically on young children to determine the extent of the problem. It is these young children who are purported to be the most affected but have been the least studied, according to podiatry PhD student Angela Evans from UniSA’s School of Health Sciences.

“Growing pains affect a lot of young children (36.9 per cent of children in our study) to the point that they’re seeing a health professional or taking pain medication. It has also been estimated in other studies that children with growing pains who frequently see medical or other health practitioners can take up between five and seven per cent of health care resources, which is considerable,“ Evans says.

“Children who are otherwise healthy and well can be described as having growing pains when they experience recurrent leg pain and aches in both legs. It is important to note that these pains occur in the muscle groups, not in the joints, which differentiates them from more serious conditions.

“Growing pains typically start late in the day, particularly at night, and are more likely to occur after increased activity. The level of distress varies from complaints by some children to crying and screaming by others, depending on the intensity of the pain. In terms of frequency, it seems to go in spates, from say, four times in a week to nothing for a month, making it difficult to monitor,“ Evans says.

“While there’s a lot that we still don’t know about growing pains, it has been classically diagnosed by the exclusion of more serious conditions.

“It is important for health care professionals to be more aware of this too often dismissed childhood problem where, in about 70 per cent of cases, there is a family history of growing pains.“

Evans is conducting world-first research to compare children with and without growing pains to see if there is a difference anatomically in their foot posture.

“Preliminary testing suggests that there is an association between children’s foot posture and leg pains and we are investigating to see whether that theory is a factor,“ she says.

“We have developed the best methods for accurately measuring the anatomical part of the foot for children aged four, five and six by using ultrasound to make sure that measurements are valid.“

Research that leads to identifying the cause of growing pain will help children and their parents to better manage the condition and reduce the number of visits to health professionals, according to Evans, whose research is being supervised by Associate Professor Sheila Scutter, Dean of Teaching and Learning in the Division of Health Sciences. UNISANews
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Old 8th December 2004, 05:39 AM
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Theres no doubt that orthoses help symptoms of children with lower leg aches as demonstrated by A.Evans. We see this on a daily basis. The greatest effect of such devices is most likely on soft tissues and muscle function as opposed to recumbent leg growth as documented in the original article. It raises the old question "do growing bones hurt" ???
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Old 30th August 2005, 05:23 PM
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From the Australasian Podiatry Council Conference in Christchurch, NZ:

Angela Evans
Are Foot Posture and Functional Health Differrent in Children with Growing Pains?

180 children; surveyed for growing pains and several health status measures.
Several foot posture measures used (parts of FPI; navicular height and drop; etc).

No clinical differences found in foot posture between those with growing pains and without.
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  #7  
Old 30th August 2005, 07:47 PM
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Default Growing Pains in Children and Sports Injuries in Adults Share Common Etiologies

Over the past decade, I have often stated that the podiatry and medical communities should be able to clearly see that children's "growing pains" are nothing more than a form of sports or athletic injury that we see commonly in adults. Children run and play most of the day. The normal running, jumping and playing activities that children perform on a daily basis, when combined with suboptimal structure and function of the foot and lower extremity, will lead to increased abnormal tissue stresses which will cause pain and injury.

These athletic injuries, for some reason, have been called "growing pains" in children. However, if an adult goes out and runs, jumps and plays the same number of hours per day that a child does, develops similar aches and pains, we say they are "overdoing it" and have developed a "sports injury".

From my perspective of seeing many children with "growing pains" and adults with "sports injuries" of the lower extremities for over 20 years, these two sets of injuries occur due to the same reasons. Therefore, children's growing pains should be treated just like sports injuries in adults: modified rest, ice, stretching, shoegear changes, over-the-counter orthoses and possibly custom foot orthoses.
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  #8  
Old 30th August 2005, 10:03 PM
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Default Growing Pains in Children

I just went back over the Precision Intricast Newsletters I have done over the past few years and found that my August 2003 Newsletter was titled "Growing Pains in Children" where I discussed the research by many authors including Angela Evans' wonderful JAPMA paper from 2003.

Here a few excerpts from the newsletter:

Quote:
Later, in 1992, Kirby and Green noted in children with flexible flatfoot deformity that also had lower extremity symptoms due to “growing pains”, the vast majority had their symptoms resolve with the use of foot orthoses. Due to the excellent therapeutic results that foot orthoses showed in clinically resolving growing pains, we concluded that “mechanical instability of the foot during weightbearing activities may, therefore, be a substantial cause of growing pains in some children” (Kirby KA, Green DR: Evaluation and Nonoperative Management of Pes Valgus, pp. 295-327, in DeValentine, S.(ed), Foot and Ankle Disorders in Children. Churchill-Livingstone, New York, 1992).
And the last paragraph of the newsletter:

Quote:
Children run and play a good portion of their days, much more than adults realize. It seems logical to assume that since adults commonly seek medical attention for their over-use injuries from running and playing too much for their individual biomechanical make-ups, children also experience pain in their extremities that is likely related to their running and playing too much for their individual biomechanical make-ups. Therefore, the common and painful condition of “growing pains”, which has probably been erroneously attributed to the growth process for the past 180 years, is now getting new attention in the medical literature that will hopefully result in many more children being treated successfully and not continuing to suffer needlessly with lower extremity pain.
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  #9  
Old 26th September 2005, 08:06 PM
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I'm in the process of putting my 4yo into some orthotics in the hope of reducing the number of times he complains of sore feet and legs (and to reduce the crying and sleeplessness that goes with it!)

Just through observation (& not particularly vigilant obs at that!) I can equate the nights he waks up with sore legs to the days when he's been busiest. I've always assuemd it was "overuse" rather than growing pains.
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Old 19th January 2006, 09:09 AM
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Dear all experts
Having treated children with "growing pains" for approx 20 years of my career I can say that in a large majority of children that complain consistently about "aching legs", reluctance to walk distances and asking to be carried because "my legs are tired", a functional biomechanical abnormality can be found. Most commonly an overpronated gait pattern. If this is successfully addressed then I become a miracle worker as far as the parent is concerned. The child stops complaining and waking at night and not wanting to walk. This is I accept not backed up by a research project done by me but on my clinical expereince. I think it would be an interesting Masters study if I can ever pluck up the energy to do one. In the meantime I will continue to treat these children in the same way as it gets the results the parent (and I hope the child) wants.
I accept as Mr Kirby states that some of these pains may be as a result of overuse as a child who runs around a lot may be very alike the pains an athelete gets when training but a lot of the chilren that I see arn't running around because of the pans that they get and because the legs are tired as a result of the compenatory nature of the gait patterns they are exhibiting. Once this is controlled then they can run around more withou the pain. I am doing a presentation on this very subject to colleagues so would value any information/ researchthat I could use to support this. I think the pain levels vary from child to child just as pain levels vary from adult to adult depending on their individual pain thesholds so it is difficult to quantify whether the "crying with pain" child is actually in more pain than the child who is just complaining. it is good to know that research is going on in these areas.
Kate Grundy
Podiatrist NHS UK
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Old 29th July 2006, 03:16 PM
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“Growing pains” in young children: A study of the profile, experiences and quality of life issues of four to six year old children with recurrent leg pain
The Foot Volume 16, Issue 3 , September 2006, Pages 120-124
Quote:
Background
Growing pains is a common yet misunderstood condition which presents frequently to health professionals and appears to be significantly under reported. Little is known about the profile of affected versus unaffected children.

Method
This research used a validated questionnaire (USAGPQ) for parents of children aged four to six years to explore characteristics such as basic anthropometry, family history, physical activity levels, quality of life (QoL) and the pain experience of affected children. The health professional consulted and resulting treatment or investigations were also surveyed in a systematic random sample of 743 children in South Australia.

Results
Based on parental responses: only 35.9% children were seen by health professionals; pain medication was the most common intervention prescribed (17.1%); a family history of growing pains was reported in 69.8% cases. In no reported cases was a muscle stretching program used, despite this measure having best evidence for management. Children experiencing growing pains had significantly greater body weight (approximately 5% greater), same activity levels and in a minority of cases (5.7%) reduced QoL estimates.

Conclusions
This study shows that the management of growing pains is not evidence based and occurs in isolation from health care professionals. The finding of growing pains being associated with increased weight requires further exploration given the concerns of childhood obesity. This prevalent condition affects some young children with considerable frequency and may impact quality of life of these children. This condition is under reported, mismanaged and too often disregarded by health care professionals.
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Old 31st August 2006, 06:34 PM
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Todays British Medical Journal has this editorial:
Growing Pains (only those with institutional access can get the full article
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Old 27th September 2006, 11:49 AM
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For those nay-sayers who doubts mechanical stress is a factor, ask how many kids have growing pains in their arms, hands, etc. If they grow at the same rate as feet and legs, why do not children have growing pains there? I have had similar very good results with children over many years who I have treated as being biomechanically greater at risk or developing overuse stress injuries.

Last note: orthodonic dentristry seems to approach alignment with an early intervention attitude to prevent teeth, jaws from taking on an injurious attitude.
Best regards
Freeman Churchill, Certified Pedorthist (Canada)
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Old 1st October 2006, 09:30 PM
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As a mother and pod ,whatever order you please, my 6years old has experience "Growing pains" -unilaterally in his left calf -occasionally for approx 3 years and only after a busy day and going to bed later than usual Panadol helped
Can growing pains be unilateral? yvonnespod
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Old 8th October 2006, 12:17 PM
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Exclamation unnilateral growing pains

As another mother and Pod, please get your 6 year old with unilateral pains checked for Juvenile Arthritis, my Daughter suffered for 3 years before she was correctly diagnosed, she only has it in one knee but we were told for ages she had growing pains/ cartilage problems/ attention seeking etc etc
:) Don't panic though, they do grow out of it, my daughter is now 15 and hasn't had a flare for 6 months. And yes, orthotics help a lot, damage limita tion is imperative to prevent problems later on.
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Old 8th February 2007, 07:54 PM
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Default Re: Unilateral Growing Pains

Dear Mum/Pods,

Have you done a biomechanical assessment rulling out scoliosis,hip drop, leg length discrepancy? Orthotics work well wiith these patients if the biomechanical difference in R and L is not excessive. Have son 9 who developed aches early, and loves to run. Wears soft full length orthotics.

Pod777
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  #17  
Old 23rd April 2007, 09:19 PM
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Default Re: Growing Pains

Tuesday, April 24, 2007. 6:45am (AEST)

Sydney researchers begin study into 'growing pains'

Researchers at a Sydney hospital are investigating the cause of growing pains in children, but it appears the cause is unlikely to have anything to do with growing.

Nocturnal limb pain syndrome, or growing pains, is a common childhood complaint.

The syndrome affects many children aged between three and 13, with pain usually felt in the legs during the night.

Associate Professor David Champion of the Sydney Children's Hospital says there have been many theories about the causes, including growth, flat fleet and bone fatigue, but none have been proven.

He says it is likely to be caused by something similar to that of severe headaches.

"Migraine is clearly a disordered function of the nervous system and so it appears likely that growing pains syndrome is disordered function in nervous system," he said.

He says the hospital is looking for child volunteers to be part of the research that involves non-invasive tests and the findings will be released later this year.

He says he hopes the study will shed some light on the problem (more from the ABC...)
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Old 23rd April 2007, 10:54 PM
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Default Re: Growing Pains

Quote:
Originally Posted by Hylton Menz
He says it is likely to be caused by something similar to that of severe headaches.

"Migraine is clearly a disordered function of the nervous system and so it appears likely that growing pains syndrome is disordered function in nervous system," he said.


Migraine's??

Huh?!?

The dear professor seems to have grabbed two utterley different pathologies and brought them together from out of nowhere.

Is my education at fault - or does this seem like a complete load of nonsense - whatever current 'growing pains' theory you subscribe to!

Someone please enlighten me.

LL
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Old 23rd November 2007, 06:24 AM
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Default Re: Growing Pains

Are foot posture and functional health different in children with growing pains?
ANGELA MARGARET EVANS, SHEILA DOREEN SCUTTER
Pediatrics International (OnlineEarly Articles).
doi:10.1111/j.1442-200X.2007.02493.x
Quote:
Background: The aim of the present paper was to investigate and compare findings of foot posture and functional health between groups of children aged 4–6 years with and without leg pain (described as "growing pains"). The null hypothesis: that there is no difference in measures of either foot posture or functional health between groups of children with and without leg pain.

Methods: A stratified random sample of children was obtained. The children were identified with and without leg pain using a validated questionnaire for parents. The examiner was blind to the children’s pain status. The schools and child care centers were from each geographical quadrant of metropolitan Adelaide and a northern rural region of South Australia. One hundred and eighty children (94 boys, 86 girls) entered and completed the study. Children whose parents returned a completed questionnaire and consent form were entered into the study. All participants were assessed by the one examiner. The foot posture measures used were those found to be most reliable in previous studies and for which the intra-rater reliability of the examiner was ascertained.

Results: Initial analysis of foot posture measures between the leg pain and no leg pains groups indicated a statistically significant result for the measure of navicular height, but only on the left side (P = 0.033). Logistic regression modeling showed that navicular height (left foot only) was positively yet weakly related to growing pains (odds ratio, 1.072; 95% confidence interval: 0.991–1.160) and the effect was not significant (P = 0.08). Measures of functional health returned many statistically significant yet weakly correlated relationships.

Conclusions: The null hypothesis of the present study was supported in terms of clinical significance. While the foot posture measure of navicular height on the left foot was statistically significant it was not predictive for growing pains nor clinically significant as a measure between groups. The present study does not support the anatomical theory for growing pains and does not find a meaningful relationship between foot posture or functional health measures and leg pain in young children.
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Old 28th July 2008, 08:29 PM
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Default Re: Growing Pains

Growing pains: contemporary knowledge and recommended practice

Angela M Evans

Journal of Foot and Ankle Research 2008, 1:4doi:10.1186/1757-1146-1-4

Published: 28 July 2008

Abstract (provisional)

Background
Leg pain in children, described as growing pains, is a frequent clinical presentation seen by an array of health care professionals. Described since 1823, growing pains continues to puzzle practitioners, yet diagnostic criteria and evidence based treatment is available.

Methods
The medical literature has been searched exhaustively to access all articles (English language) pertaining to leg pains in children which are ascribed to being 'growing pains'.

Results
The literature, whilst plentiful in quantity and spanning two centuries, is generally replete with reiterated opinion and anecdote and lacking in scientific rigour. The author searched 45 articles for relevance, determined according to title, abstract and full text, resulting in a yield of 22 original studies and 23 review articles. From the original studies, one small (non-blinded) randomised controlled trial that focused on GP treatment with leg muscle stretching was found. Nine prevalence studies were found revealing disparate estimates. Ten cohort (some case-controlled) studies, which investigated pain attribute differences in affected versus unaffected groups, were found. One series of single case experiment designs and one animal model study were found.

Conclusions
Growing pains is prevalent in young children, presents frequently in the health care setting where it is poorly managed and is continuing to be researched. A common childhood complaint, growing pains needs to be acknowledged and better managed in the contemporary medical setting.
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Old 1st May 2011, 01:16 AM
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Default Re: Growing Pains in Children

Press Release:
Study is the first to link sleep duration to infant growth spurts

Quote:
A study in the May 1 issue of the journal SLEEP is the first to show that increased bursts of sleep among infants are significantly associated with growth spurts in body length.

Results show that infants had irregular bursts of sleep, with 24-hour sleep duration increasing at irregular intervals by an average of 4.5 hours per day for two days. The number of sleep episodes per day also increased in intermittent bursts of an average of three extra naps per day for two days. These peaks in total daily sleep duration and number of sleep episodes were significantly associated with measurable growth spurts in body length, which tended to occur within 48 hours of the recorded bursts of sleep. Further analysis found that the probability of a growth spurt increased by a median of 43 percent for each additional sleep episode and 20 percent for each additional hour of sleep.

“The results demonstrate empirically that growth spurts not only occur during sleep but are significantly influenced by sleep,” said principal investigator and lead author Dr. Michelle Lampl, Samuel Candler Dobbs Professor in the department of anthropology at Emory University in Atlanta, Ga. “Longer sleep corresponds with greater growth in body length.”

Lampl added that the results may be particularly helpful for parents, who can become easily frustrated by the variability and unpredictability of an infant’s sleep patterns.

“On a practical, everyday level, it helps parents understand their infant’s behavior and patterns,” she said.

The study involved 23 parents who consistently recorded daily sleep records for their infant, providing 5,798 daily records for analysis. The median age of the 14 girls and nine boys at study onset was 12 days. All infants were healthy at birth and free of colic or medical complications during their first year. For a duration ranging from four to 17 continuous months, growth in total body length was assessed using the maximum stretch technique, which was performed semi-weekly for 18 infants, daily for three infants and weekly for two infants.

According to Lampl and co-author Michael Johnson, PhD, professor of pharmacology in the University of Virginia Health System, the exact nature of the relationship between sleep biology and bone growth is unclear. However, they noted that the secretion of growth hormone is known to increase after sleep onset and during the stage of slow wave sleep. This change in hormonal signals during sleep could stimulate bone growth, which would support anecdotal reports of “growing pains,” the aching limbs that can wake children at night.

Although a statistically significant relationship between bursts of sleep and growth spurts was found in all infants, the correspondence was imperfect. Some sleep alterations occurred without a growth spurt, and not every growth spurt was preceded by a burst of sleep.

Lampl and Johnson speculate that in some cases growth may have occurred in other parts of the body. For example, another new study they are publishing this month found that infant head circumference grows in intermittent, episodic spurts. They also suggest that sleep may be only one component of an integrated, physiological system that underlies growth timing.

The study is also significant, added Lampl, because it adds a novel finding to the interdisciplinary, multi-faceted body of research targeted at answering the question, “Why do we sleep?”

“It opens another door to understanding why we sleep,” she said. “We now know that sleep is a contributing factor to growth spurts at the biological level.”
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Old 31st May 2011, 01:09 AM
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Default Re: Growing Pains in Children

A SCHOOLGIRL who was told she was suffering from growing pains turned out to have a life-threatening form of cancer.
Quote:
Sophie Huntingdon was taken to a doctor suffering from aches in her knees last October.

But the 14-year-old was told the discomfort was merely down to her development.
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Old 14th June 2011, 01:08 AM
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Default Re: Growing Pains in Children

Growing Pains: A Study of 30 Cases and a Review of the Literature
Pavone, Vito, Lionetti, Elena, Gargano, Valerio, Evola, Francesco R., Costarella, Luciano, Sessa, Giuseppe
Journal of Pediatric Orthopaedics: July/August 2011 - Volume 31 - Issue 5 - p 606–609
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Background: Data from the literature regarding the clinical profile of growing pains are limited. The purpose of this study was to define the clinical features, familial history, laboratory findings, and therapeutic outcome of growing pains in children.

Methods: Thirty children (18 male and 12 female; 3 to 14 y of age) who presented with growing pains between January 2006 and December 2007 were enrolled and prospectively followed up for 1 year. The inclusion criterion was lower extremity pain, which was recurrent and lasted for >3 months. The exclusion criteria were any abnormal systemic or local symptoms and signs, joint involvement, and limp or limitation of activity. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, and serum calcium and phosphorus levels, were performed in all children.

Results: The study group had pain during the night and afternoon in 43.3% and 56.7% of cases, respectively. Both lower limbs were involved in 80% of cases, causing awakening and crying episodes in 40% and 37% of cases, respectively. The frequency of pain was as follows: daily, 5%; weekly, 45%; monthly, 35%; and every 3 months, 15%. The pains were relieved by massaging the affected site in 95% of cases and by analgesics in 5% of children. A family history of growing pains was positive in 20% of patients. All patients had laboratory tests within normal values.

Conclusion: Growing pain is a frequent noninflammatory syndrome consisting of intermittent, often annoying, pains that affect the lower extremities of children. Clinical diagnosis is easy if precise inclusion and exclusion criteria in the history and physical examinations are strictly followed. Patients and family reassurance is mandatory.
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Old 14th June 2011, 02:45 AM
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Default Re: Growing Pains in Children

Quote:
“mechanical instability of the foot during weightbearing activities may, therefore, be a substantial cause of growing pains in some children”
What Kevin said.

Funny thing about growing pains is that they are (in my experience) probably the easiest fix with orthoses. If they are "growing pains" why should that be?

And why are they never in elbows?
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Old 14th June 2011, 06:30 AM
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Default Re: Growing Pains in Children

Quote:
Originally Posted by Robertisaacs View Post
What Kevin said.

Funny thing about growing pains is that they are (in my experience) probably the easiest fix with orthoses. If they are "growing pains" why should that be?

And why are they never in elbows?
Robert:

I agree. I can't remember the last case of "growing pains" I didn't cure with custom foot orthoses. Funny, the children continued growing even with the orthoses.
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Old 23rd February 2012, 02:06 AM
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Default Re: Growing Pains in Children

Bone strength in children with growing pains: long-term follow-up
Y. Uziel, G. Chapnick, A. Oren-Ziv, L. Jaber, D. Nemet, P. Hashkes
Pediatric Rheumatology (in press)
Quote:
OBJECTIVES:
To examine the changes in bone strength in a cohort of children with `growing pains` (GP) after 5 years follow-up and the correlation with pain outcome.

METHODS:
Bone strength was measured by quantitative ultrasound. Subjects were 39 children with GP previously studied. Controls were normograms based on the measurement of bone speed of sound in 1085 healthy children. Current GP status was assessed by parental questionnaires. Bone strength was compared with pain outcome.

RESULTS:
We examined 30/39 (77%) patients after 5 years. Bone strength was significantly increased when compared to the first study (Z score 0.65±1.77 vs. -0.62±0.90, p<0.001). While overall there was no significant difference in the bone strength between the 16 (53%) patients whose GP resolved and the 14 (47%) who continued to have GP episodes (p=0.71), all 6 (20%) patients with a speed of sound Z-score <-1 continued to have GP (p=0.003).

CONCLUSIONS:
Our findings that pain improves in most patients parallel to the increase in bone strength may support the hypothesis of GP representing in some patients a local overuse syndrome
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Old 24th February 2012, 07:14 AM
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Default Re: Growing Pains in Children

Couple of question folks put in the simplest of terms. Is it the growth of bone that causes the pain or the struggle of ligaments, tendons and muscles to 'catch up'. If the latter is the case, surely a stretching regieme may be more beneficial that othoses. If, in most cases, there is overpronation, could that not just be caused by 'tight' tendons. Just a thought.
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Old 16th September 2012, 12:59 AM
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Old 27th September 2012, 08:31 PM
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Default Re: Growing Pains in Children

One of our students posted this in our internal learning forum. I have their permission to repost it here.
Quote:
“My sister was diagnosed with growing pains at the age of 6 years. At first she experienced night pain, was at the typical age and the pain was poorly isolated.

It was not until the pain become localised, occurred both night and day, began to restrict her activity was this diagnoses questioned. Slowly over many months a hard mass on her tibia began to form. Tests revealed that she had a very large osteoblastoma on her tibia.“
A timely reminder on the seriousness that "growing pains" needs to be given.
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Old 28th September 2012, 05:19 AM
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Default Re: Growing Pains in Children

Quote:
she experienced night pain
I believe the rule is that as soon as a paeds patient reports this, they need an Xray...
Was the poorly isolated pain unilateral or bilateral??
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