Growing pains in children: epidemiological analysis in a Mediterranean population

Abstract

Objectives: Recurrent lower limb pains (growing pains) constitute the most frequent cause of musculoskeletal pain in children. Despite the fact that the international literature has presented numerous cases over the years, which have led to various hypotheses and theories, the disorder's exact nature and aetiology remain unclear.

Methods: Our study aims to examine both the epidemiological profile of the children affected by the disorder and the measures taken by parents or medical specialists for their management. In addition, we tried to link the existing theories with the findings of our study, to ascertain whether these were verified by the epidemiological findings. This retrospective study investigated the appearance of lower limbs in the 12-month period before the visit of the children to our department. The study included a total of 532 children, aged 4-12, while the data were collected through semi-structured interviews including a mix of open and closed questions.

Results: One hundred and thirty of these children presented growing pains, meeting Petersen's criteria. The frequency of the disorder was 24.5%. Most times, they appeared after intensive physical exercise, while their development was not linked to the children's BMI. The main therapeutic approach used by parents was massaging the painful lower limbs and, to a lesser extent, the administration of anti-inflammatory agents.

Conclusions: The data analysis proves that this is a benign disorder with an unknown pathophysiological mechanism. In addition, their presence is not strongly related to anatomic or orthopaedic disorders, a fact opposing anatomical theory. On the contrary, their appearance after intensive physical exercise at a percentage of up to 78.5% leads us to hypothesise that it is a lower local extremity overuse syndrome, which seems in accordance with many experimental data in international literature.