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Growing pains.

Q My 5-year-old son has a lot of pains at night. He keeps waking up and crying, and seems to be very upset. He goes back to sleep, but I think there really is something bothering him. Is this "growing pains"?

A It could be, but there are a few other questions to answer to make sure that there couldn't be something else going on.

"Growing pains" are very characteristic, and can usually be diagnosed based only on the pattern of pain. They occur a little more commonly in boys than girls, usually from age 4-8 or so. The pain is almost always limited to the nighttime hours, and often wakes a child from sleep. During the day, children with growing pains do not limp or complain of pain.

At night, when these children wake up, they'll usually complain of pain in one or both legs, and in a vague location that often varies from side to side or site to site on subsequent nights. When children are asked to point at where it hurts, they'll rub over an area rather than point specifically at one exact point.

It's important to stress that the pain itself is very real--"growing pains" is not a euphemism for "faking it." These kids are genuinely uncomfortable, and often scared. Fortunately, it's easy to treat. Gentle massage or a heating pad works very well, or a single dose of a pain medicine like ibuprofen or acetaminophen will help. Though they may seem to be very uncomfortable, growing pains usually subside in 20-30 minutes, so everyone can go back to sleep.

Recent research has shown that in some cases, vitamin D deficiency can contribute to nighttime muscle and bone pains. Parents of children with apparent growing pains may want to try a vitamin D supplement. The AAP currently recommends a vitamin D supplement of 400 IU/day for almost all children, anyway.

I ask parents of children with growing pains to beware of the following "red flags." If any of these are present, it's not typical of growing pains, and further evaluation may be necessary:

* Pain or limp during the day.

* Pain that persistently affects one specific joint or place.

* Associated fever, weight loss, or other symptoms of potentially serious disease.

* Pain that's become more and more intense as weeks go by.

Growing pain itself is quite common, and usually falls into such a specific pattern that it's easy to diagnose and treat. You should discuss your child's discomfort with your pediatrician, and go through the history in detail to make sure that there aren't any "red flags" that could signal a more serious problem.

By Roy Benaroch, MD

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Title Annotation:Pediatric Insider
Author:Benaroch, Roy
Publication:Pediatrics for Parents
Geographic Code:1USA
Date:Nov 1, 2010
Words:444
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