Most people are no strangers to growing pains. The phrase is widely used in common parlance and by health professionals to describe muscle or joint pain in children and teens.

But new analysis suggests there is no clear medical definition of the condition nor its causes. In a review of 145 studies globally, Australian researchers found no scientific consensus on what growing pains really are and how they should be diagnosed.

Prof Steven Kamper, a co-author of the review from the University of Sydney, said generally accepted criteria for growing pains “tends to be a version of: pain in both legs, somewhere between the ages of three and 12, at … night, and no significant limitation that the child has during the day – so able to play and go to school.”

But the review, published in the journal Pediatrics, found that clinical definitions of the condition were vague and in some instances outright contradictory.

Half of the analysed studies reported leg pain as a feature, but some reported that growing pains occurred in the arms. “Quite a few say [it affects] muscles, but some say joints,” Kamper said. “Some say it is an episodic thing, so it comes and goes recurrently. Others say it’s something you get and it stays with you – it’s persistent.”

Of the studies analysed, 93% made no mention of growth or growth spurts, and more than 80% did not include the age of onset in their definition.

Kamper said the findings raised the question: “Does it have anything to do with growth at all?”

“If it doesn’t, maybe we need to be a bit more upfront in that this is pain that we don’t know the cause of,” he said. “It’s most likely [growing pains] is used as a catch all for, ‘We don’t really know what’s wrong’.”

Various hypotheses have been previously floated for what may cause such pains, including low vitamin D levels, changes to blood flow during growth, or mechanical factors such as bones growing at a faster rate than muscles or tendons. “None of those theories are backed by compelling evidence,” Kamper said.

The prevalence of such pains also varied tenfold – different studies estimated it affected between 3.5% to 37% of young people.

The phrase “growing pains” originates from a French book, published in 1823, called Maladies de la Croissance (diseases of growth).

The authors of the review are now suggesting the term should not be used in isolation. “We are left asking the question why is the term ‘growing’ used in the first place?” they wrote.

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“If clinicians or researchers are going to use that term, then they shouldn’t use that on its own – it needs to come with some additional explanation … about what they think is going on, [with] validation of the experience, potential treatment options and so on,” Kamper said.

“This sits in a space where we really don’t understand what’s happening with kids who are experiencing pain. If we compare the volume of research which looks at investigating what pain is, how to treat it, what the prognosis is in children … it’s a tiny proportion of what’s done in adults.

“If we don’t research what’s going on, we’re shooting a bit blind if we’re trying to treat these children.”



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